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1.
Actas esp. psiquiatr ; 48(4): 154-162, jul.-ago. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193803

RESUMO

INTRODUCCIÓN; Diversos estudios internacionales muestran altas tasas de depresión e ideación suicida en estudian-tes de medicina. Sin embargo, no se dispone de datos específicos en estudiantes españoles. El objetivo del presente estudio es determinar la prevalencia de síntomas depresivos e ideación suicida en la Facultad de Medicina de Valencia, así como su relación con otras variables de interés. METODOLOGÍA: En abril de 2018 se invitó a todos los estudiantes matriculados en el Grado de Medicina de la Universitat de València a completar el Inventario de Depresión de Beck (BDI-II). Los estudiantes participaron de forma voluntaria y las respuestas fueron anonimizadas. RESULTADOS: Un total de 858 estudiantes (69,2% mujeres) respondieron la encuesta (tasa de respuesta del 44,7%). Más de un tercio de la muestra (39,1%) presentaba síntomas depresivos, de intensidad leve a grave, mientras que un 15,8% referían ideación suicida reciente. Se encontraron niveles de síntomas depresivos significativamente más ele-vados en las mujeres, así como en aquellos con una peor satisfacción con los resultados académicos, una mayor percepción de necesidad de apoyo psicológico por problemas de salud mental recientes y en los que habían consultado alguna vez con profesionales sanitarios por un problema de salud mental (29,4%). CONCLUSIONES: Estos resultados son consistentes con la prevalencia de síntomas depresivos en estudiantes de medicina de otros países e invitan a realizar estudios comparativos en otras universidades españolas. Las facultades de medicina deberían incorporar intervenciones para proveer a los estudiantes de herramientas que mejoren su salud mental


INTRODUCTION:. Several international studies show high rates of depression and suicidal ideation in medical students. However, no specific data is available in Spanish students. The aim of this study is to determine the prevalence of de-pressive symptoms and suicidal ideation in the Faculty of Medicine of Valencia, as well as its relationship with other variables of interest. METHODS: In April 2018, all students enrolled in the Medical Degree of the University of Valencia were invited to complete the Beck Depression Inventory (BDI-II). The students participated voluntarily and the answers were anonymized. RESULTS: A total of 858 students (69.2% women) completed the survey (response rate of 44.7%). More than a third of the sample (39.1%) had depressive symptoms, of mild to severe intensity, while 15.8% of the students report-ed recent suicidal ideation. Significantly higher levels of depressive symptoms were found in women, as well as in those with a worse satisfaction with academic results, a greater perception of the need for psychological support due to re-cent mental health problems and in those who had ever consulted with health professionals for a mental health problem (29.4%). CONCLUSIONS: These results are consistent with the prevalence of depression in medical students from other countries and suggest comparative studies in other Spanish universities. Medical schools should incorporate interventions to provide students with tools that improve their mental health


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Estudantes de Medicina/estatística & dados numéricos , Estudantes de Medicina/psicologia , Depressão/complicações , Depressão/psicologia , Ideação Suicida , Espanha/epidemiologia , Prevalência
2.
Obes Res Clin Pract ; 14(4): 383-385, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32763110

RESUMO

INTRODUCTION: The goal was to assess individuals' weight changes and their connections with depressive symptoms, optimism and physical activity. METHOD: 4379 Spanish citizens, 16-84 years, participated. RESULTS: Most participants declared no weight changes. Males, young and obese individuals had greater weight variability. Depressive symptoms were linked to larger weight changes. Optimism and MVPA followed a descending pattern from ≥-3 kg. MVPA minutes/week and fulfilling physical activity recommendations were inversely associated to weight changes. CONCLUSION: The COVID-19 confinement impacted individuals' weight, expanding depreobesity to include weight loss. Optimism and physical activity seemed to be "protective elements".


Assuntos
Betacoronavirus , Peso Corporal , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Exercício Físico , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Depressão/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Otimismo , Pandemias , Adulto Jovem
3.
JAMA ; 324(7): 651-662, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32809002

RESUMO

Importance: Mental health comorbidities are increasing worldwide and worsen outcomes for people with diabetes, especially when care is fragmented. Objective: To assess whether collaborative care vs usual care lowers depressive symptoms and improves cardiometabolic indices among adults with diabetes and depression. Design, Setting, and Participants: Parallel, open-label, pragmatic randomized clinical trial conducted at 4 socioeconomically diverse clinics in India that recruited patients with type 2 diabetes; a Patient Health Questionnaire-9 score of at least 10 (range, 0-27); and hemoglobin A1c (HbA1c) of at least 8%, systolic blood pressure (SBP) of at least 140 mm Hg, or low-density lipoprotein (LDL) cholesterol of at least 130 mg/dL. The first patient was enrolled on March 9, 2015, and the last was enrolled on May 31, 2016; the final follow-up visit was July 14, 2018. Interventions: Patients randomized to the intervention group (n = 196) received 12 months of self-management support from nonphysician care coordinators, decision support electronic health records facilitating physician treatment adjustments, and specialist case reviews; they were followed up for an additional 12 months without intervention. Patients in the control group (n = 208) received usual care over 24 months. Main Outcomes and Measures: The primary outcome was the between-group difference in the percentage of patients at 24 months who had at least a 50% reduction in Symptom Checklist Depression Scale (SCL-20) scores (range, 0-4; higher scores indicate worse symptoms) and a reduction of at least 0.5 percentage points in HbA1c, 5 mm Hg in SBP, or 10 mg/dL in LDL cholesterol. Prespecified secondary outcomes were percentage of patients at 12 and 24 months who met treatment targets (HbA1c <7.0%, SBP <130 mm Hg, LDL cholesterol <100 mg/dL [<70 mg/dL if prior cardiovascular disease]) or had improvements in individual outcomes (≥50% reduction in SCL-20 score, ≥0.5-percentage point reduction in HbA1c, ≥5-mm Hg reduction in SBP, ≥10-mg/dL reduction in LDL cholesterol); percentage of patients who met all HbA1c, SBP, and LDL cholesterol targets; and mean reductions in SCL-20 score, Patient Health Questionnaire-9 score, HbA1c, SBP, and LDL cholesterol. Results: Among 404 patients randomized (mean [SD] age, 53 [8.6] years; 165 [40.8%] men), 378 (93.5%) completed the trial. A significantly greater percentage of patients in the intervention group vs the usual care group met the primary outcome (71.6% vs 57.4%; risk difference, 16.9% [95% CI, 8.5%-25.2%]). Of 16 prespecified secondary outcomes, there were no statistically significant between-group differences in improvements in 10 outcomes at 12 months and in 13 outcomes at 24 months. Serious adverse events in the intervention and usual care groups included cardiovascular events or hospitalizations (4 [2.0%] vs 7 [3.4%]), stroke (0 vs 3 [1.4%]), death (2 [1.0%] vs 7 [3.4%]), and severe hypoglycemia (8 [4.1%] vs 0). Conclusions and Relevance: Among patients with diabetes and depression in India, a 12-month collaborative care intervention, compared with usual care, resulted in statistically significant improvements in a composite measure of depressive symptoms and cardiometabolic indices at 24 months. Further research is needed to understand the generalizability of the findings to other low- and middle-income health care settings. Trial Registration: ClinicalTrials.gov Identifier: NCT02022111.


Assuntos
Pressão Sanguínea , LDL-Colesterol/sangue , Depressão/terapia , Diabetes Mellitus Tipo 2/terapia , Hemoglobina A Glicada/análise , Adulto , Idoso , Comportamento Cooperativo , Depressão/complicações , Países em Desenvolvimento , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Autogestão , Fatores Socioeconômicos
4.
Psychiatry Res ; 291: 113294, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32763552

RESUMO

To cope with Covid-19 and limits its spread among residents, retirement homes have prohibited physical contact between residents and families and friend and, in some cases, even between residents or between residents and caregivers. We investigated the effects of measures against Covid-19 on the mental health of participants with Alzheimer's disease (AD) who live in retirement homes in France. We instructed on-site caregivers to assess depression and anxiety in participants with mild AD who live in retirement homes. Fifty-eight participants consented to participate in the study. The participants rated their depression and anxiety during and before the Covid-19 crisis. Participants reported higher depression (p = .005) and anxiety (p = .004) during than before the Covid-19 crisis. These increases can be attributed to the isolation of the residents and/or to the drastic changes in their daily life and care they receive. While, in their effort to prevent infections, retirement homes are forced to physically separate residents from the outside world and to drastically reduce residents' activities, these decisions are likely to come at a cost to residents with AD and their mental health.


Assuntos
Doença de Alzheimer/complicações , Ansiedade/diagnóstico , Infecções por Coronavirus , Depressão/diagnóstico , Instituição de Longa Permanência para Idosos , Pandemias , Pneumonia Viral , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Ansiedade/complicações , Ansiedade/psicologia , Betacoronavirus , Cuidadores , Depressão/complicações , Depressão/psicologia , Feminino , França , Humanos , Masculino , Casas de Saúde , Índice de Gravidade de Doença
5.
Pediatrics ; 146(3)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32817440

RESUMO

OBJECTIVES: To assess the relation between exposure to maternal depression before age 5 and 5 domains of developmental vulnerability at school entry, overall, and by age at exposure. METHODS: This cohort study included all children born in Manitoba, Canada, who completed the Early Development Instrument between 2005 and 2016 (N = 52 103). Maternal depression was defined by using physician visits, hospitalizations, and pharmaceutical data; developmental vulnerability was assessed by using the Early Development Instrument. Relative risk of developmental vulnerability was assessed by using log-binomial regression models adjusted for characteristics at birth. RESULTS: Children exposed to maternal depression before age 5 had a 17% higher risk of having at least 1 developmental vulnerability at school entry than did children not exposed to maternal depression before age 5. Exposure to maternal depression was most strongly associated with difficulties in social competence (adjusted relative risk [aRR] = 1.28; 95% confidence interval [CI]: 1.20-1.38), physical health and well-being (aRR = 1.28; 95% CI: 1.20-1.36), and emotional maturity (aRR = 1.27; 95% CI: 1.18-1.37). For most developmental domains, exposure to maternal depression before age 1 and between ages 4 and 5 had the strongest association with developmental vulnerability. CONCLUSIONS: Our finding that children exposed to maternal depression are at higher risk for developmental vulnerability at school entry is consistent with previous findings. We extended this literature by documenting that the adverse effects of exposure to maternal depression are specific to particular developmental domains and that these effects vary depending on the age at which the child is exposed to maternal depression.


Assuntos
Depressão/complicações , Deficiências do Desenvolvimento/etiologia , Nível de Saúde , Mães/psicologia , Habilidades Sociais , Pré-Escolar , Estudos de Coortes , Intervalos de Confiança , Depressão/diagnóstico , Depressão/epidemiologia , Depressão Pós-Parto/complicações , Feminino , Humanos , Lactente , Manitoba/epidemiologia , Risco , Irmãos/psicologia , Fatores Socioeconômicos , Adulto Jovem
6.
PLoS One ; 15(8): e0237329, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32822365

RESUMO

BACKGROUND: Although the suicide rate in China has decreased over the past 20 years, there have been reports that the younger age group has been experiencing an increased incidence of completed suicide. Given that undergraduate groups are at higher risks of suicidality, it is important to monitor and screen for risk factors for suicidal ideation and behaviors to ensure their well-being. OBJECTIVE: To examine the risk and protective factors contributing to suicidality among undergraduate college students in seven provinces in China. METHODS: We conducted a cross-sectional study involving 13,387 college students from seven universities in Ningxia, Shandong, Shanghai, Jilin, Qinghai, Shaanxi, and Xinjiang. Data were collected using self-report questionnaires. RESULTS: Higher scores in the psychological strain, depression, anxiety, stress, and psychache (psychological risk factors for suicidality) and lower scores in self-esteem and purpose in life (psychological protective factors against suicidality) were associated with increased suicidality among undergraduate students in China. Demographic factors which were associated with higher risks of suicidality were female gender, younger age, bad academic results, were an only child, non-participation in school associations, and had an urban household registration. Perceived good health was protective against suicidality. CONCLUSIONS: Knowing the common risk and protective factors for suicidality among Chinese undergraduate students is useful in developing interventions targeted at this population and to guide public health policies on suicide in China.


Assuntos
Autoimagem , Estudantes/psicologia , Ideação Suicida , Suicídio/prevenção & controle , Ansiedade/complicações , Ansiedade/epidemiologia , Ansiedade/psicologia , China/epidemiologia , Estudos Transversais , Depressão/complicações , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Fatores de Proteção , Fatores de Risco , Autorrelato/estatística & dados numéricos , Estresse Psicológico/complicações , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Estudantes/estatística & dados numéricos , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Inquéritos e Questionários , Universidades/estatística & dados numéricos , Adulto Jovem
7.
Intern Med ; 59(13): 1589-1595, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32612062

RESUMO

Objective Depression in patients with coronary artery disease (CAD) has been a risk factor for adverse cardiovascular events. However, personality types, strategies for coping with stressors, and their associations with depression have not been fully elucidated in patients with CAD. This study explored depression in patients with CAD and examined its association with personality types and coping strategies. Methods A prospective observational study of 89 patients with CAD was conducted between August 2016 and July 2018. The presence of depression and type D personality and types of coping strategies were measured one month after percutaneous coronary intervention. A logistic regression analysis was performed to identify characteristics associated with depression. Results Generally, the incidence of depression and type D personality was 55.1% and 44.9%, respectively. The incidence of depression in patients with type D and non-type D personality was 72.5% and 40.8%, respectively. Patients with type D personality coped less frequently using a planning strategy but frequently using a responsibility-shifting strategy. A logistic regression analysis showed that the presence of depression was significantly associated with type D personality and inversely associated with a planning strategy. Conclusion The high prevalence of depression in patients with CAD was associated with type D personality and a low rate of adoption of a planning strategy. Specific coping interventions in patients with CAD with type D personality may be potential targets for improving coping skills and preventing the development of depression.


Assuntos
Adaptação Psicológica , Doença da Artéria Coronariana/psicologia , Depressão/complicações , Personalidade Tipo D , Idoso , Depressão/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea , Prevalência , Estudos Prospectivos , Fatores de Risco
9.
Artigo em Inglês | MEDLINE | ID: mdl-32668576

RESUMO

Online poker is a form of gambling where an element of skill may influence the outcome of the game. 'Tilt' in poker describes an episode during which the player can no longer control their game by rational decisions. It leads to a loss of control over the game, a loss of emotional regulation, higher cognitive distortion, and a loss of money. This phenomenon, experienced by most players, could be the gateway to excessive gambling. The aim of this study was to assess the links between the frequency of tilt episodes, cognitive distortion, anxiety, depression, sensation seeking and excessive online poker gambling. Our sample is composed of 291 online poker players, with a mean age of 33.8 years (SD = 10.6). Participants completed an online self-assessment questionnaire, measuring the frequency of tilt episodes, cognitive distortion, anxiety, depression and impulsivity. The findings indicated that the frequency of tilt episodes and cognitive distortion were the only significant predictors of excessive online gambling (respectively, r = 0.49 and r = 0.20). Tilt frequency and cognitive distortion were strongly correlated (GRCS, r = 0.60), moderate to low correlations were found for tilt and anxiety (HADS, r = 0.40), and positive and negative urgency (UPPS, r = 0.27). To date, tilt has seldom been studied, and could improve our understanding of online poker gamblers. It could be a new means of identifying at risk gamblers, and thus facilitating preventive measures specifically adapted to this population.


Assuntos
Ansiedade/psicologia , Transtornos Cognitivos/psicologia , Depressão/psicologia , Jogo de Azar/psicologia , Comportamento Impulsivo , Internet , Adulto , Ansiedade/complicações , Transtornos de Ansiedade , Transtornos Cognitivos/complicações , Depressão/complicações , Jogo de Azar/complicações , Humanos , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Inquéritos e Questionários
10.
J Int Med Res ; 48(7): 300060520939337, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32674650

RESUMO

OBJECTIVE: This study aimed to describe the emergency responses to coronavirus disease 2019 (COVID-19) for pregnant patients at our hospital and their effect on hospital operations and patients' outcomes. METHODS: We developed strategies to prevent hospital-associated transmission of COVID-19 in obstetric care. Infrastructure, including the fever clinic and wards, were modified. Outpatient volume was controlled and screening processes were strictly performed. Verification of the virus was compulsory for non-surgery and non-emergency patients. Emergency operations were performed in a negative pressure theater with surgeons fully protected. Outcomes were analyzed and the patients' characteristics were evaluated. The effect of intervention on depressed and anxious patients was assessed. Data from the first 2 months of 2019 and 2020 were compared. RESULTS: No in-hospital COVID-19 infections occurred in our unit. During the epidemic, patient volume significantly decreased. While major characteristics of patients were similar, a higher prevalence of gestational hypertension was found in 2020 than in 2019. Psychological interventions showed optimistic effects in ameliorating depression and anxiety at the beginning of the COVID-19 pandemic. CONCLUSIONS: Our strategies were effective in preventing in-hospital infection of COVID-19 and reassuring women about the safety of pregnancy. Monitoring and managing psychological issues were necessary during this critical period.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Controle de Infecções , Obstetrícia/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Complicações Infecciosas na Gravidez/prevenção & controle , Adulto , Ansiedade/complicações , Temperatura Corporal , China/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/complicações , Feminino , Hospitais , Humanos , Recém-Nascido , Obstetrícia/tendências , Avaliação de Resultados em Cuidados de Saúde , Pacientes Ambulatoriais , Pneumonia Viral/psicologia , Gravidez , Complicações Infecciosas na Gravidez/psicologia , Telemedicina/tendências , Adulto Jovem
11.
Arch Microbiol ; 202(10): 2689-2695, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32725599

RESUMO

Depression disorder is one of the most common psychological recognitions that characterized by sadness, low self-confidence, and disinterest in every activity. Considering evidence showing the effects of toxoplasmosis on the psychological disease, this study conducted to investigate the serological and molecular aspects of Toxoplasma gondii infection among patients with depression. In this study, after selecting the patients with depression and control groups under the supervision of a psychologist, the blood samples were collected and the serum samples and buffy coat were separated. The specific anti-Toxoplasma IgG antibodies in serum samples were evaluated using the commercial ELISA kit. Then the desired region of the Toxoplasma B1 gene was amplified using the specific primers. To confirm the specificity of primers to amplify the B1 gene of Toxoplasma, the extracted PCR product was sequenced. The overall prevalence of toxoplasmosis in patients with depression was 59.8 and 60.19% by ELISA and PCR, respectively. In the control group, the prevalence of Toxoplasma was 56.3 and 40.2% by serology and PCR. There was a significant correlation between the prevalence of toxoplasmosis and depression. Moreover, a significant difference was found between the variables of age, sex, kind of nutrition, level of education and toxoplasmosis among the two cases and control groups. The higher prevalence of Toxoplasma infection among patients with depression compared with the control group indicates the probable impact of this parasite on depression and exacerbates its symptoms, which requires special attention of specialist physicians and patient's relatives.


Assuntos
Anticorpos Antiprotozoários/sangue , Depressão/complicações , Depressão/parasitologia , Toxoplasma , Toxoplasmose/complicações , Toxoplasmose/epidemiologia , Anticorpos Antiprotozoários/genética , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Genes de Protozoários/genética , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Masculino , Reação em Cadeia da Polimerase , Prevalência , Fatores de Risco , Toxoplasma/genética , Toxoplasma/imunologia , Toxoplasmose/imunologia
12.
Enferm. nefrol ; 23(2): 168-174, abr.-jun. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194134

RESUMO

INTRODUCCIÓN: Los pacientes ancianos en diálisis peritoneal tienen mayor riesgo de presentar fragilidad, pérdida de autonomía, comorbilidad y disminución de calidad de vida. OBJETIVO: evaluar la fragilidad, dependencia, depresión y calidad de vida, analizando la repercusión de la fragilidad sobre el tiempo de aprendizaje de la técnica y la aparición del primer episodio de peritonitis. MATERIAL Y MÉTODO: estudio descriptivo retrospectivo. Se incluyeron pacientes mayores de 70 años, desde septiembre 2016 a 2017, las peritonitis hasta final de 2018. Se estudiaron variables demográficas, modalidad dialítica, índices de Charlson, Barthel y escala de depresión de Yesavage Escala de fragilidad clínica, calidad de vida, tiempo de entrenamiento y primera peritonitis. RESULTADOS: Se incluyeron 25 pacientes, 56% hombres, edad media 76,77±5,34 años, el 72% estaban en diálisis peritoneal manual. La media del Charlson 7,88±2,06, del Barthel 88,27±24,66 y del Short form 12 health survey 32,96±8,61. El 40% tenían algún grado de fragilidad, 24% depresión, el 28% precisaban ayuda o estaban institucionalizados. Tiempo medio de entrenamiento en pacientes frágiles fue 16,77±7,93 horas vs no frágiles 15,20±5,06 (p = 0,42). Se recogieron 16 episodios de peritonitis, repartidos al 50%, tiempo medio de aparición frágiles 315,13±212,73 días vs no frágiles 320,25±224,91 (p = 0,44). CONCLUSIONES: La mayoría de los pacientes realizan diálisis peritoneal manual de forma autónoma. Tienen un nivel de fragilidad bajo, no presentan depresión y gozan de buena calidad de vida para su edad. No existe diferencia en el tiempo de aprendizaje entre los dos grupos. Las peritonitis se reparten al 50% en frágiles y no frágiles


INTRODUCTION: Elderly patients on peritoneal dialysis have a higher risk of presenting fragility, loss of autonomy, comorbidity and decreased quality of life. OBJECTIVE: To assess frailty, dependency, depression and quality of life, analysing the repercussion of frailty on the learning time of the technique and the appearance of the first episode of peritonitis. MATERIAL AND METHOD: descriptive retrospective study. Patients older than 70 years were included, from September 2016 to 2017, episodes of peritonitis until the end of 2018. Demographic variables, dialysis modality, Charlson index, Barthel index, Yesavage geriatric depression scale, clinical fragility scale, quality of life scale, training time and first peritonitis were collected. RESULTS: 25 patients were included, 56% men, mean age 76.77±5.34 years, 72% were on manual peritoneal dialysis. The mean value for the Charlson index was 7.88±2.06, for Barthel index 88.27±24.66 and for the Short form 12 health survey 32.96±8.61. 40% had some degree of frailty, 24% depression, 28% needed help or were institutionalized. Average training time in fragile patients was 16.77±7.93 hours versus non-fragile 15.20±5.06 (p = 0.42). 16 episodes of peritonitis were collected, distributed to 50% between both groups. The mean time of appearance of fragile people was 315.13±212.73 days versus 320.25±224.91 days for non-fragile ones (p = 0.44). CONCLUSIONS: Most of the patients perform manual peritoneal dialysis autonomously. They have low frailty levels, no depression and enjoy a good quality of life for their age. There is no difference in learning time between the two groups. Peritonitis is equally distributed in fragile and non-fragile patients


Assuntos
Humanos , Masculino , Idoso , Idoso de 80 Anos ou mais , Diálise Peritoneal/enfermagem , Peritonite/enfermagem , Idoso Fragilizado , Qualidade de Vida/psicologia , Avaliação Geriátrica/métodos , Peritonite/prevenção & controle , Fatores de Risco , Depressão/complicações , Estudos Retrospectivos , Apoio Social , Inquéritos e Questionários , Repertório de Barthel
13.
Neurology ; 95(7): e793-e804, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32591472

RESUMO

OBJECTIVE: To test the hypothesis that repetitive head impacts (RHIs), like those from contact sport play and traumatic brain injury (TBI) have long-term neuropsychiatric and cognitive consequences, we compared middle-age and older adult participants who reported a history of RHI and/or TBI with those without this history on measures of depression and cognition. METHODS: This cross-sectional study included 13,323 individuals (mean age, 61.95; 72.5% female) from the Brain Health Registry who completed online assessments, including the Ohio State University TBI Identification Method, the Geriatric Depression Scale (GDS-15), and the CogState Brief Battery and Lumos Labs NeuroCognitive Performance Tests. Inverse propensity-weighted linear regressions accounting for age, sex, race/ethnicity, and education tested the effects of RHI and TBI compared to a non-RHI/TBI group. RESULTS: A total of 725 participants reported RHI exposure (mostly contact sport play and abuse) and 7,277 reported TBI (n = 2,604 with loss of consciousness [LOC]). RHI (ß, 1.24; 95% CI, 0.36-2.12), TBI without LOC (ß, 0.43; 95% CI, 0.31-0.54), and TBI with LOC (ß, 0.75; 95% CI, 0.59-0.91) corresponded to higher GDS-15 scores. While TBI with LOC had the most neuropsychological associations, TBI without LOC had a negative effect on CogState Identification (ß, 0.004; 95% CI, 0.001-0.01) and CogState One Back Test (ß, 0.004; 95% CI, 0.0002-0.01). RHI predicted worse CogState One Back Test scores (ß, 0.02; 95% CI, -0.01 to 0.05). There were RHI × TBI interaction effects on several neuropsychological subtests, and participants who had a history of both RHI and TBI with LOC had the greatest depression symptoms and worse cognition. CONCLUSIONS: RHI and TBI independently contributed to worse mid- to later-life neuropsychiatric and cognitive functioning.


Assuntos
Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas/complicações , Depressão/complicações , Inconsciência/complicações , Idoso , Cognição/fisiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
Rev Esp Geriatr Gerontol ; 55(5): 272-278, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32595054

RESUMO

OBJECTIVES: To analyze differences by age group in anxiety, depression, loneliness and comorbid anxiety and depression in young people, middle aged adults and older adults during the lock-down period at home due to the COVID-19 pandemic, and to explore the association between negative self-perceptions of aging and psychological symptoms controlling by age group. METHOD: Participants are 1501 people (age range 18 to 88 years). Anxiety, sadness, loneliness and self-perceptions of aging were assessed. The sample was divided according to the age group and quartiles (lower, intermediate levels, and higher) of anxiety, sadness, loneliness and self-perceptions of aging. RESULTS: Older adults reported lower levels of anxiety and sadness than middle aged adults, and middle aged adults reported lower levels than younger participants. Middle aged adults reported the lowest loneliness, followed by older adults and younger participants. For each age group, those with more negative self-perceptions of aging reported higher anxiety, sadness and loneliness. More comorbid anxiety and sadness was found in younger adults and less in older adults; more depressed participants in the middle aged group, and more older adults and less younger participants were found in the group with the lowest levels of anxiety and sadness. For all the age groups, participants with high levels of comorbid anxiety and sadness are those who report the highest scores in negative self-perceptions of aging. CONCLUSIONS: Older adults reported lower psychological anxiety, sadness and loneliness than the other age groups. Having negative self-perceptions of aging damage psychological health irrespective of the chronological age.


Assuntos
Envelhecimento/psicologia , Ansiedade/complicações , Ansiedade/psicologia , Infecções por Coronavirus , Depressão/complicações , Depressão/psicologia , Solidão/psicologia , Pandemias , Pneumonia Viral , Quarentena/psicologia , Tristeza/psicologia , Autoimagem , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Depressão/epidemiologia , Humanos , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Adulto Jovem
15.
PLoS One ; 15(6): e0231563, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32589635

RESUMO

BACKGROUND: The aim of this study was to assess the association between anxiety and depression with physical and sensory functional difficulties, among adults living in five low and middle-income countries (LMICs). METHODS AND FINDINGS: A secondary data analysis was undertaken using population-based disability survey data from five LMICs, including two national surveys (Guatemala, Maldives) and 3 regional/district surveys (Nepal, India, Cameroon). 19,337 participants were sampled in total (range 1,617-7,604 in individual studies). Anxiety, depression, and physical and sensory functional difficulties were assessed using the Washington Group Extended Question Set on Functioning. Age-sex adjusted logistic regression analyses were undertaken to assess the association of anxiety and depression with hearing, visual or mobility functional difficulties. The findings demonstrated an increased adjusted odds of severe depression and severe anxiety among adults with mobility, hearing and visual functional difficulties in all settings (with ORs ranging from 2.0 to 14.2) except for in relation to hearing loss in India, the Maldives and Cameroon, where no clear association was found. For all settings and types of functional difficulties, there was a stronger association with severe anxiety and depression than with moderate. Both India and Cameroon had higher reported prevalences of physical and sensory functional difficulties compared with Nepal and Guatemala, and weaker associations with anxiety and depression. CONCLUSION: People with physical and sensory functional difficulties are more likely to report experiencing depression and anxiety. This evidence supports the need for ensuring a good awareness of mental health among those working with individuals with physical and sensory functional difficulties in LMICs. This implies that these practitioners must have the skills to identify anxiety and depression. Furthermore, mental health services must be available and accessible to patients with these conditions, which will likely require further programmatic scale-up in these LMIC settings.


Assuntos
Ansiedade/patologia , Depressão/patologia , Perda Auditiva/patologia , Transtornos da Visão/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/complicações , Ansiedade/epidemiologia , Depressão/complicações , Depressão/epidemiologia , Países em Desenvolvimento , Feminino , Perda Auditiva/complicações , Perda Auditiva/epidemiologia , Humanos , Índia/epidemiologia , Modelos Logísticos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Prevalência , Índice de Gravidade de Doença , Inquéritos e Questionários , Transtornos da Visão/complicações , Transtornos da Visão/epidemiologia , Adulto Jovem
16.
PLoS One ; 15(6): e0234346, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32530934

RESUMO

BACKGROUND: The two part Kimberley Mum's Mood Scale (KMMS) has been developed and validated as a culturally appropriate perinatal depression and anxiety screening tool for Aboriginal women living in the sparsely populated Kimberley region of North West Australia. As part of implementation aspects of user acceptability were explored to improve clinical utilisation of the KMMS. METHODS: Eighteen health professionals involved in perinatal care participated in an online survey or a qualitative semi-structured interview. Ten Aboriginal women (who held administrative, professional or executive roles) were subsequently interviewed in depth to further explore aspects of KMMS user acceptability. RESULTS: Many of the health professionals were not using the second part of the KMMS (the psychosocial discussion tool). Time constraints and a perception that the KMMS is only appropriate for women with literacy issues were identified by health professionals as significant barriers to KMMS uptake. In contrast the Aboriginal women interviewed considered the KMMS to be important for literate Aboriginal women and placed high value on having the time and space to 'yarn' with health professionals about issues that are important to them. CONCLUSION: Implementing the KMMS across the Kimberley region requires health professionals to be trained. It also requires strategic engagement with health services to ensure health professionals and mangers understand the rationale and significance of the KMMS and are engaged in its successful implementation.


Assuntos
Afeto , Saúde Mental , Grupo com Ancestrais Oceânicos/psicologia , Assistência Perinatal/métodos , Escalas de Graduação Psiquiátrica , Adulto , Ansiedade/complicações , Ansiedade/diagnóstico , Assistência à Saúde Culturalmente Competente , Depressão/complicações , Depressão/diagnóstico , Feminino , Pessoal de Saúde , Humanos , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/psicologia , Austrália Ocidental , Adulto Jovem
17.
PLoS One ; 15(6): e0234264, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32542009

RESUMO

OBJECTIVES: Androgen deprivation therapy (ADT) has seen increasing use as a prostate cancer treatment in recent years and has proven medically effective in numerous contexts. The treatment, however, is associated with a host of side effects including depression. Managing the psychological wellbeing of prostate cancer patients is important for maximizing their survival outcomes. Thus, this study aimed to evaluate depressive symptomatology in patients with androgen deprivation therapy (ADT) compared with that in patients who underwent prostatectomy and to explore the factors that affect depressive symptoms, which might occur during ADT. METHODS: One hundred and seven patients undergoing ADT (ADT group) and prostatectomy (Operation group) were enrolled. Adjustments were made for differences in characteristics between groups using a propensity score model with stabilized weights before treatment. Depressive symptoms between groups were compared using the Beck Depression Inventory (BDI) before treatment and six months after treatment initiation. To identify factors affecting depressive symptoms during ADT, multivariate regression analysis was performed on the mean change in BDI score, age, body mass index, testosterone level, prostate-specific antigen level, the international index of erectile function (IIEF), and the Gleason score. RESULTS: The BDI score significantly increased in the ADT group compared to the operation group six months after treatment initiation (p < 0.001). Multivariate regression analysis revealed that before ADT, the BDI score was higher by 0.446 according to the IIEF. During ADT, the BDI score increased by 1.579 according to changes in BMI (p = 0.021) and decreased by 0.01 according to changes in testosterone levels (p = 0.034). CONCLUSION: Depressive symptoms can be exacerbated in prostate cancer patients undergoing ADT. Efforts are needed to diagnose and treat depression appropriately, especially if depressive symptoms change in ADT patients with a high IIEF score before ADT, or reduced testosterone levels or increased BMI during ADT.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Depressão/complicações , Depressão/diagnóstico , Prostatectomia , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/cirurgia , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias da Próstata/complicações , Neoplasias da Próstata/patologia , Qualidade de Vida
18.
PLoS One ; 15(6): e0233849, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497153

RESUMO

BACKGROUND: Sleep is a natural, restorative, physiological process that is characterized by perceptual disengagement from and unresponsiveness to whatever going around, which is reversible. Sleep quality refers to a sense of being rested and refreshed after waking up from sleep. People living with HIV/AIDS (PLWHA) are vulnerable to poor sleep quality as they suffer from social stigma and Anti-Retroviral drug side effects. The study aimed to examine the quality of sleep and its associated factors among people living with HIV/AIDS attending Anti-Retroviral Therapy (ART) clinic at Hawassa University comprehensive specialized hospital. METHOD: Institutional based cross-sectional study was conducted among PLWHA attending ART clinic at Hawassa University comprehensive specialized hospital from May 1-30, 2019. A systematic random sampling technique was used to select an estimated 422 study participants and data was collected using interviewer-administered technique. Sleep Quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Data were entered and analyzed using SPSS 22 software. Bivariable and multivariable logistic regression model was fitted to identify factors associated with quality of sleep. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance with P-value less than 0.05. RESULT: Out of 422 respondents, 389 participated in the study giving a response rate of 92.1%. The prevalence of poor quality of sleep among study participants was found to be 57.6% (95% CI: 54.72, 60.48). 31.9% (124) and 30.6% (119) of study participants had anxiety and depression respectively. Being between the age of 55-64 years (AOR = 5.7, 95% CI (1.9, 17.8), Age ≥ 65 (AOR:6.6, 95% CI (1.2, 36.9), Monthly income <1656 Ethiopian Birr (ETB) (AOR = 2.17, 95% CI (1.06, 4.4), having anxiety (AOR = 4.4, 95% CI (2.12, 9.2), having depression (AOR = 4.97, 95% CI (2.28, 10) and poor social support (AOR = 2.9, 95% CI (1.16, 7.3) were factors associated with poor quality of sleep. CONCLUSION: The prevalence of poor quality of sleep among PLWHA was significantly high. Average monthly income, age, anxiety, depression, and social support were found to be significantly associated with poor sleep quality. Health care professionals working at the ART clinic need to assess the sleep pattern of ART clients, give psychoeducation on the prevention and management of sleep pattern problems.


Assuntos
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/psicologia , Antirretrovirais/uso terapêutico , HIV , Síndromes da Apneia do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Síndrome de Imunodeficiência Adquirida/virologia , Adolescente , Adulto , Idoso , Antirretrovirais/efeitos adversos , Ansiedade/complicações , Estudos Transversais , Depressão/complicações , Etiópia/epidemiologia , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza , Prevalência , Síndromes da Apneia do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/etiologia , Estigma Social , Adulto Jovem
19.
PLoS One ; 15(6): e0227935, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32502150

RESUMO

BACKGROUND: Perinatal depression (PND) can interfere with HIV care engagement and outcomes. We examined experiences of PND among women living with HIV (WLWH) in Malawi. METHODS: We screened 73 WLWH presenting for perinatal care in Lilongwe, Malawi using the Edinburgh Postnatal Depression Scale (EPDS). We conducted qualitative interviews with 24 women experiencing PND and analyzed data using inductive and deductive coding and narrative analysis. RESULTS: Women experienced a double burden of physical and mental illness, expressed as pain in one's heart. Receiving an HIV diagnosis unexpectedly during antenatal care was a key contributor to developing PND. This development was influenced by stigmatization and social support. CONCLUSIONS: These findings highlight the need to recognize the mental health implications of routine screening for HIV and to routinely screen and treat PND among WLWH. Culturally appropriate mental health interventions are needed in settings with a high HIV burden.


Assuntos
Depressão/complicações , Infecções por HIV/psicologia , Complicações Infecciosas na Gravidez/psicologia , Adulto , Feminino , Humanos , Malaui , Gravidez , Inquéritos e Questionários
20.
Parasitol Res ; 119(8): 2649-2657, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32583161

RESUMO

Trichomonas vaginalis is the most common nonviral sexually transmitted infection. According to the 2019 WHO cancer report, cervical cancer is the fourth most frequent cancer in women. However, previous research, which has not included a large-scale study to date, has revealed that Trichomonas vaginalis increases cervical cancer risk. In this study, we investigated a group of Asian females in Taiwan to determine the association between trichomoniasis and the risk of developing cervical lesions, including cancer, neoplasm, and dysplasia. We conducted a nested case-control study by using the National Health Insurance (NHI) program database in Taiwan. The International Classification of Diseases, 9th Revision classifications (ICD-9-CM) was used to categorize all of the medical conditions for each patient in the case and control groups. The adjusted odds ratio (AOR) and 95% confidence interval (CI) for the association between trichomoniasis and cervical lesions were estimated using multivariable conditional logistic regression to adjust for all comorbidities and variables. In total, 54,003 individuals were enrolled in the case group and 216,012 were enrolled in the control group. Trichomonas vaginalis exposure had a significant association with cervical lesions (AOR 2.656, 95% CI = 1.411-5.353, p = 0.003), especially cervical cancer (AOR 3.684, 95% CI = 1.622-6.094, p = 0.001). In patients with both trichomoniasis and depression, the relative risk increased 7.480-fold compared to those without trichomoniasis or depression. In conclusion, female patients with Trichomonas vaginalis exposure had a significantly higher risk of developing cervical lesions (especially cervical cancer) than those without exposure.


Assuntos
Tricomoníase/complicações , Trichomonas vaginalis/patogenicidade , Doenças do Colo do Útero/patologia , Doenças do Colo do Útero/parasitologia , Adulto , Estudos de Casos e Controles , Depressão/complicações , Depressão/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Razão de Chances , Taiwan/epidemiologia , Tricomoníase/epidemiologia , Doenças do Colo do Útero/epidemiologia , Doenças do Colo do Útero/psicologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/parasitologia , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/psicologia
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