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1.
Environ Health Prev Med ; 24(1): 70, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31787069

RESUMO

AIMS: This study focused on the newest evidence of the relationship between forest environmental exposure and human health and assessed the health efficacy of forest bathing on the human body as well as the methodological quality of a single study, aiming to provide scientific guidance for interdisciplinary integration of forestry and medicine. METHOD: Through PubMed, Embase, and Cochrane Library, 210 papers from January 1, 2015, to April 1, 2019, were retrieved, and the final 28 papers meeting the inclusion criteria were included in the study. RESULT: The methodological quality of papers included in the study was assessed quantitatively with the Downs and Black checklist. The methodological quality of papers using randomized controlled trials is significantly higher than that of papers using non-randomized controlled trials (p < 0.05). Papers included in the study were analyzed qualitatively. The results demonstrated that forest bathing activities might have the following merits: remarkably improving cardiovascular function, hemodynamic indexes, neuroendocrine indexes, metabolic indexes, immunity and inflammatory indexes, antioxidant indexes, and electrophysiological indexes; significantly enhancing people's emotional state, attitude, and feelings towards things, physical and psychological recovery, and adaptive behaviors; and obvious alleviation of anxiety and depression. CONCLUSION: Forest bathing activities may significantly improve people's physical and psychological health. In the future, medical empirical studies of forest bathing should reinforce basic studies and interdisciplinary exchange to enhance the methodological quality of papers while decreasing the risk of bias, thereby raising the grade of paper evidence.


Assuntos
Ensaios Clínicos Controlados como Assunto , Exposição Ambiental , Florestas , Depressão/prevenção & controle , Depressão/terapia , Humanos , Saúde Mental , Aptidão Física/fisiologia , Terapia Recreacional
2.
Medicine (Baltimore) ; 98(51): e18471, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31861026

RESUMO

This study aimed to compare the Hamilton anxiety rating/Hamilton depression rating (HAMA/HAMD) scale scores and blood pressure (BP) goal achievement associated with the use of valsartan-amlodipine single-pill combinations (SPCs) versus valsartan and amlodipine combination in adult hypertensive patients.A total of 476 hypertensive patients were randomly assigned into the SPC (valsartan-amlodipine) and control (valsartan and amlodipine combination) groups. All patients had an uncontrolled BP (160-179/100-109 mm Hg). BP goal was <140/90 mm Hg. Cox proportional hazards regression analysis was used to analyze the likelihood of HAMA/HAMD scales, SPCs, control group, and daily dosage number. Kaplan-Meier analysis was used to estimate the rates of BP goal achievement over time among the 2 groups.A total of 476 patients were included in the study, and 439 patients completed the follow-up and received the index drug therapy. There was a significant difference in BP between the 2 groups on days 28, 42, and 56. Patients who received SPCs had a significantly higher rate of BP goal achievement over time (P = .000). The average HAMD scores in the SPC and control groups were 5.54 and 5.49 and 6.06 and 6.21 on days 28 and 56, respectively. The average HAMA scores in the SPC and control groups were 7.41 and 7.13 and 7.90 and 8.01 on days 28 and 56, respectively. The means of HAMD and HAMA scores were 5.826 and 7.614, respectively. The higher the HAMA/HAMD scores, the lower was the BP goal achievement. The number of drugs taken by the patients was associated with the HAMA and HAMD scores. There was no significant difference between HAMA scores of patients taking 1 tablet daily (7.22 ±â€Š1.885) and those taking two-tablets daily (7.38 ±â€Š1.953) (P = .408). However, when these scores were compared to those of patients taking 4 tablets daily (8.08 ±â€Š2.285), a significant difference was observed (P = .000, P = .000).Hypertensive patients treated with valsartan-amlodipine SPCs were significantly more likely to achieve BP goal and have lesser HAMA/HAMD scores compared to patients treated with valsartan and amlodipine combination.


Assuntos
Combinação Anlodipino e Valsartana/uso terapêutico , Anti-Hipertensivos/administração & dosagem , Ansiedade/prevenção & controle , Depressão/prevenção & controle , Hipertensão/tratamento farmacológico , Combinação Anlodipino e Valsartana/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Feminino , Humanos , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
3.
Nurs Res ; 68(6): 494-500, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693556

RESUMO

BACKGROUND: Recognizing the effects of acculturation on quality of life and emotional health, especially during pregnancy, we developed an intervention that would target these factors in order to improve maternal well-being during the prenatal period and potentially improve infant outcomes, particularly preterm birth for Mexican-American women (Latinas). OBJECTIVE: The purpose of these pilot studies was to test the acceptability, feasibility, and preliminary efficacy of the mastery lifestyle intervention (MLI) to decrease depressive and anxiety symptoms and improve coping as implemented in prenatal clinics with culturally homogenous groups of Latinas. METHODS: The MLI was tested in three small pilot studies (n = 15), one in El Paso, Texas (an urban area), and two in Bastrop, Texas (a rural area outside Austin), for acceptability and feasibility. A pretest/posttest, quasi-experimental design was used with pregnant self-identified Mexican-American Latinas at 14-20 weeks' gestation. Measures of anxiety, depressive symptoms, and positive and negative coping were used. RESULTS: Feasibility was a success in terms of implementation of the MLI in an active prenatal clinic setting and the use of electronic tablets for data collection and entry of data into REDcap. Satisfaction was high, with the location of the MLI being at their primary OB/GYN clinic. Participants reported that six intervention sessions appear to be ideal as was the class length of 1.5 to 2 hours. On Cohen's d, there were medium to large effect size decreases in depressive and anxiety symptoms and small to medium effect size decreases in the use of negative coping strategies and small effect sizes for increases in positive coping strategies. DISCUSSION: Pilot testing of the MLI indicated that it was well accepted from the participants and feasible as a culturally tailored behavioral therapy administered in a group setting by nurse practitioners. Our initial pilot results also suggest preliminary efficacy as indicated by moderate to large Cohen's d effect sizes for depression and anxiety.


Assuntos
Ansiedade/prevenção & controle , Depressão/prevenção & controle , Estilo de Vida/etnologia , Americanos Mexicanos/psicologia , Complicações na Gravidez/prevenção & controle , Cuidado Pré-Natal , Aculturação , Adaptação Psicológica , Adulto , Ansiedade/etnologia , Depressão/etnologia , Estudos de Viabilidade , Feminino , Humanos , Projetos Piloto , Gravidez , Complicações na Gravidez/etnologia , Qualidade de Vida , Texas
4.
Lancet Psychiatry ; 6(12): 1011-1020, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31734106

RESUMO

BACKGROUND: Rates of anxiety and depression are increasing among children and young people. Recent policies have focused on primary prevention of mental disorders in children and young people, with schools at the forefront of implementation. There is limited information for the comparative effectiveness of the multiple interventions available. METHODS: We did a systematic review and network meta-analysis, searching MEDLINE, Embase, PsycINFO, and Cochrane Central Register of Controlled trials for published and unpublished, passive and active-controlled randomised and quasi-randomised trials. We included educational setting-based, universal, or targeted interventions in which the primary aim was the prevention of anxiety and depression in children and young people aged 4-18 years. Primary outcomes were post-intervention self-report anxiety and depression, wellbeing, suicidal ideation, or self-harm. We assessed risk of bias following the Cochrane Handbook for Systematic Reviews of Interventions. We estimated standardised mean differences (SMD) using random effects network meta-analysis in a Bayesian framework. The study is registered with PROPSERO, number CRD42016048184. FINDINGS: 1512 full-text articles were independently screened for inclusion by two reviewers, from which 137 studies of 56 620 participants were included. 20 studies were assessed as being at low risk of bias for both random sequence generation and allocation concealment. There was weak evidence to suggest that cognitive behavioural interventions might reduce anxiety in primary and secondary settings. In universal secondary settings, mindfulness and relaxation-based interventions showed a reduction in anxiety symptoms relative to usual curriculum (SMD -0·65, 95% credible interval -1·14 to -0·19). There was a lack of evidence to support any one type of intervention being effective to prevent depression in universal or targeted primary or secondary settings. Comparison-adjusted funnel plots suggest the presence of small-study effects for the universal secondary anxiety analysis. Network meta-analysis was not feasible for wellbeing or suicidal ideation or self-harm outcomes, and results are reported narratively. INTERPRETATION: Considering unclear risk of bias and probable small study effects for anxiety, we conclude there is little evidence that educational setting-based interventions focused solely on the prevention of depression or anxiety are effective. Future research could consider multilevel, systems-based interventions as an alternative to the downstream interventions considered here. FUNDING: UK National Institute for Health Research.


Assuntos
Ansiedade/prevenção & controle , Depressão/prevenção & controle , Meta-Análise em Rede , Serviços de Saúde Escolar , Adolescente , Ansiedade/terapia , Criança , Pré-Escolar , Terapia Cognitivo-Comportamental , Depressão/terapia , Humanos , Ideação Suicida
5.
Prax Kinderpsychol Kinderpsychiatr ; 68(7): 639-653, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31711401

RESUMO

Shame and Compassion: Potential Mechanisms Behind Bullying and Depressive Symptoms With a prevalence of 11 % depression is a relevant topic for child- and adolescent-psychiatry. Different factors play a role in genesis and maintenance of depressive symptoms. Shame-proneness and experience with bullying are discussed as reinforcing factors. On the other hand self-compassion is considered to be a protective factor. In this study it is analyzed, whether shame-proneness and self-compassion moderate the influence of bully-experience on depressive symptoms. Data of depressive adolescent in-patients (n = 37) and healthy controls (n = 19) is analyzed. It could be shown that high shame-proneness reinforces the influence of bully-experience on depressive symptoms. General self-compassion has no moderating influence. However, self-kindness is a protective factor against the negative impact of bully-experience on depressive symptoms. Results are discussed regarding their relevance for therapy and prevention.


Assuntos
Bullying/psicologia , Depressão/psicologia , Empatia , Fatores de Proteção , Vergonha , Adolescente , Depressão/prevenção & controle , Depressão/terapia , Transtorno Depressivo/prevenção & controle , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Humanos
6.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46827

RESUMO

Um estudo de 2016 publicado na revista The Lancet indica que países em desenvolvimento têm taxa de cerca de 25% de depressão durante a gestação. Para auxiliar na prevenção, um grupo de pesquisadores da Faculdade de Medicina da USP (FMUSP) criou um aplicativo capaz de identificar sintomas depressivos em gestantes e mães. O Motherly, como foi chamado, indica intervenções para evitar maiores riscos e também incentiva a procura por ajuda profissional de acordo com o quadro apresentado.


Assuntos
Depressão Pós-Parto , Depressão/prevenção & controle , Gravidez , Gravidez na Adolescência
7.
J Athl Train ; 54(10): 1061-1066, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31633407

RESUMO

CONTEXT: Many factors can affect the injury risk and quality of life among high school athletes. Early sport specialization and club sport participation may be components to consider when assessing the injury risk and quality of life. OBJECTIVE: To investigate patient-reported quality-of-life and injury-history measures among adolescent athletes at different sport-specialization levels and to compare these measures between those who did and those who did not report participating in club sports. DESIGN: Cross-sectional study. SETTING: High school athletic facility. PATIENTS OR OTHER PARTICIPANTS: High school student athletes 13 to 18 years of age were recruited and tested during their annual preseason athletic physical examinations. MAIN OUTCOME MEASURE(S): Our primary grouping variables were sport-specialization level (classified as low, moderate, or high) and club sport participation (organized sport outside of traditional school athletics). Our outcome variables were the Patient-Reported Outcome Measurement Information System Pediatric Profile-37 rating, Severity Measure for Depression-Child score, and injury history. RESULTS: A total of 97 individuals participated (mean age = 15.2 ± 1.1 years; 38% female). Relatively similar proportions of individuals reported participating at each level of sport specialization (low = 34%, moderate = 40%, high = 26%). Forty-six (48%) participants stated they participated in club sports. No differences were evident in quality of life (P values = .15-.92 across domains), depression (P = .60), or injury history (P > .70) among the specialization groups. Those who described participating in club sports had a higher proportion of time-loss musculoskeletal injuries (63% versus 29%; P = .002) and of injuries requiring imaging, injection, a cast, a brace, or crutches (72% versus 46%; P = .013) than those who did not. CONCLUSIONS: Although no injury-history differences were found among the sport-specialization groups, a higher proportion of club sport athletes than nonclub sport athletes reported a history of injury. Club sports are generally seen as more competitive, and the higher number of injuries seen in this setting could be related to a higher level of play among club sport athletes.


Assuntos
Atletas , Traumatismos em Atletas , Depressão , Qualidade de Vida , Especialização , Estudantes , Adolescente , Atletas/psicologia , Atletas/estatística & dados numéricos , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/prevenção & controle , Traumatismos em Atletas/psicologia , Estudos Transversais , Depressão/etiologia , Depressão/fisiopatologia , Depressão/prevenção & controle , Feminino , Humanos , Masculino , Medidas de Resultados Relatados pelo Paciente , Medição de Risco , Fatores de Risco , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Estados Unidos
8.
Medicine (Baltimore) ; 98(39): e17307, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574859

RESUMO

To investigate the cognitive and psychological outcomes of pediatric allogeneic HSCT survivors in China.A total of 135 3 to 18 years old children and adolescents who underwent allo-HSCT and survived at least 3 months post-HSCT were recruited and completed the assessments. Cognitive and psychological functions were assessed via age-appropriate standardized measures. Clinical information was extracted from the medical records.Forty one 3 to 6 years old children completed Psychological Questionnaires for 3 to 6 years Children. The scores of 21(51.2%) children in cognitive development dimension, 18(43.9%) in motor development dimension, 16(39.0%) in language development and social development dimension, 15(36.6%) in emotion and will dimension and 14(34.1%) in living habits dimension were less than the standard. Fifty six 8 to 16 years old children and adolescents completed the Depression Self-rating Scale for Children and 9 (16.1%) of these met the criteria of depression. Sixty nine 7 to 16 years old children and adolescents completed the screening for Child Anxiety Related Disorders and 7 (10.1%) of these met the criteria of anxiety, especially social phobia and school phobia. Eighty nine 6 to 18 years old children and adolescents completed the Symptom Checklist-90 and 43.8% to 77.5% of these experienced mild symptoms like obsession-compulsion (77.5%), hostility (64%), and interpersonal sensitivity (60.7%). Children treated with total body irradiation (TBI) showed more cognitive impairments like motor deficits than those without TBI. Also older children and adolescents had more symptoms like psychoticism.These findings demonstrated cognitive and psychological late effects of pediatric allo-HSCT survivors in a single center in China and highlighted that the survivors conditioned with TBI had more cognitive impairments and older children and adolescents had more symptoms. Early intervention in these children and adolescents might minimize the cognitive losses and psychological effects.


Assuntos
Ansiedade , Disfunção Cognitiva , Depressão , Transplante de Células-Tronco Hematopoéticas , Complicações Pós-Operatórias , Qualidade de Vida , Adolescente , Ansiedade/diagnóstico , Ansiedade/etiologia , Ansiedade/prevenção & controle , Criança , Pré-Escolar , China/epidemiologia , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/prevenção & controle , Depressão/diagnóstico , Depressão/etiologia , Depressão/prevenção & controle , Intervenção Médica Precoce/métodos , Feminino , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Masculino , Destreza Motora , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/prevenção & controle , Técnicas Psicológicas , Sobreviventes/psicologia
9.
Biol Pharm Bull ; 42(9): 1471-1481, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31474708

RESUMO

Sutaehwan (STH) has been used in Korean medicine for the treatment of abortus habitualis such as fetal restlessness in the uterus. Previously, we reported that a modified formulation of STH, Sutaehwan-Gami, has phytoestrogen-like properties in an ovariectomized menopausal rat model. However, the therapeutic effects of STH and the precise mechanisms by which STH affects various menopausal symptoms remain poorly understood. The current study was designed to explore the effects of a modified form of STH on menopausal anxiety, depression and heart hypertrophy and its mechanisms in 4-vinylcyclohexene diepoxide (VCD)-induced menopausal mouse models. VCD-induced menopausal model mice were fed a modified form of STH, which contained water extract of 3 herbs (called STH_KP17001) at a dose of 100 or 300 mg/kg/d or as a positive control, estradiol at a dose of 0.2 mg/kg/d with standard mouse pellets for 13 weeks. The results show that STH_KP17001 significantly restored the VCD-induced weight reduction of uterine and ovary through the phosphorylation of extracellular signal-regulated kinase (ERK) and protein kinase B (AKT) in the uterus and ovary. Moreover, STH_KP17001 showed slight proliferative effects and estrogen receptor α phosphorylation in MCF-7 cells. Treatment with STH_KP17001 reversed VCD-induced anxiety and depression through AMP-activated protein kinase (AMPK) activation and brain-derived neurotrophic factor (BDNF) expression in the cerebral cortex, while improving heart hypertrophy through inactivation of inhibitor of kappaB α (IκBα) in the heart. The results indicate that STH_KP17001 improves menopause-induced anxiety, depression and heart hypertrophy, implying its protective role for the management of menopausal symptoms.


Assuntos
Ansiedade/prevenção & controle , Cardiomegalia/prevenção & controle , Depressão/prevenção & controle , Menopausa/psicologia , Extratos Vegetais/farmacologia , Animais , Cicloexenos , Modelos Animais de Doenças , Feminino , Humanos , Células MCF-7 , Medicina Tradicional Coreana , Camundongos Endogâmicos C57BL , Extratos Vegetais/isolamento & purificação , Compostos de Vinila
10.
BMC Public Health ; 19(1): 1152, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438903

RESUMO

BACKGROUND: Depression is a common and recurrent condition among older adults and is associated with poor quality of life and increased health care utilization and costs. The purpose of this pilot study was to assess the feasibility of delivering a psychosocial intervention targeting depression, and to develop the procedures to conduct a cluster randomized controlled trial among older adults registered with primary care clinics in poor neighbourhoods of São Paulo, Brazil. METHODS: We conducted a pilot study of a two-arm cluster, non-randomized controlled trial. Two primary care clinics adhering to the Family Health Strategy were allocated to either the intervention or the control arm. In the control arm, patients received enhanced usual care consisting of staff training for improved recognition and management of depression. In the intervention arm, alongside the enhanced usual care, patients received a 17-week psychosocial intervention delivered by health workers assisted with an application installed in a tablet. RESULTS: We randomly selected 579 of 2020 older adults registered in the intervention clinic to participate in the study. Among these individuals, 353 were assessed for depression and 40 (11.0%) scored at least 10 on the PHQ-9 and were therefore invited to participate. The consent rate was 33/40 (82%) with a resulting yield of 33/579 (5.7%). In the control arm, we randomly selected 320 older adults among 1482 registered in the clinic, 223 were assessed for depression and 28 (12.6%) scored 10 or above on the PHQ-9. The consent rate was 25/28 (89%), with a resulting yield of 25/320 (7.8%). Of the 33 who consented in the intervention arm, 19 (59.4%) completed all sessions. The mean PHQ-9 at follow-up (approximately 30 weeks after inclusion) were 12.3 (SD = 3.7) and 3.8 (SD = 3.9) in the control and intervention arms, respectively. Follow-up rates were 92 and 94% in control and intervention arms, respectively. CONCLUSIONS: Identification and engagement of clinics, randomization, recruitment of individuals, measures, and baseline and follow-up assessments all proved to be feasible in primary care clinics in São Paulo, Brazil. Results support the development of a definitive cluster randomized controlled trial. TRIAL REGISTRATION: This study was retrospectively registered with Registro Brasileiro de Ensaios Clínicos (ReBEC), number RBR-5nf6wd . Registered 06 August 2018.


Assuntos
Depressão/prevenção & controle , Áreas de Pobreza , Psicoterapia , Idoso , Brasil , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Atenção Primária à Saúde , Resultado do Tratamento
11.
Curr Sports Med Rep ; 18(8): 299-304, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31389872

RESUMO

Depression is a leading cause of global burden. The mainstay of treatment is pharmacological and psychological interventions. While effective, not all people will respond to those treatments and alternative approaches for preventing and treating depression are required. Recent literature has demonstrated that higher physical activity (PA) levels and exercise confer protective effects on incident depression. Also, exercise has demonstrated efficacy on reducing symptoms for people with depression. Despite its effectiveness, similar to other treatments, some people may benefit more from exercise and identifying these potential predictors of response is necessary to deal with patients' and professionals' expectations. Dropout from exercise interventions is comparable to dropout from other treatments for depression and similar to dropout from exercise in other clinical populations. However, some strategies to increase adherence are important. In the present article, we provide an updated overview of the use of PA and exercise for the prevention and treatment of depression.


Assuntos
Depressão/prevenção & controle , Depressão/terapia , Exercício , Transtorno Depressivo Maior/terapia , Humanos
12.
Psicothema (Oviedo) ; 31(3): 298-304, ago. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-185357

RESUMO

Background: Super Skills for Life (SSL) is a transdiagnostic prevention program designed for children with anxiety and depressive symptoms based on cognitive-behavioral therapy. This study is a trial of the efficacy of the SSL program to reduce anxiety and depression symptoms in a representative sample of Spanish children aged 6 to 8. Method: This cluster randomized controlled trial involved 123 Spanish-speaking children recruited from 10 schools. Schools were the unit of randomization, and were randomly assigned to one of two experimental conditions: intervention group (SSL) and waiting list control (WLC) group. Assessments were conducted before and after the 8-week intervention. Results: Generalized estimating equations showed that, compared with WLC, the intervention significantly reduced emotional symptoms of anxiety and depression. Significant improvements were also found in specific symptoms of anxiety disorders, and in the interference of anxiety in the child´s life. Conclusions: The findings of this study provide initial support for the immediate effects of SSL, suggesting that it is a valuable resource for the early reduction of anxiety and depressive symptoms in young Spanish-speaking children


Antecedentes: Super Skills for Life (SSL) es un programa de prevención transdiagnóstico diseñado para niños con síntomas de ansiedad y depresión basado en la terapia cognitivo-conductual. Se presenta un ensayo sobre la eficacia del programa SSL en la reducción de los síntomas de ansiedad y depresión en una muestra representativa de niños españoles de 6 a 8 años de edad. Método: este ensayo controlado aleatorio grupal incluyó a 123 niños hispanohablantes reclutados en 10 colegios. Los colegios fueron la unidad de aleatorización, siendo asignados aleatoriamente a una de dos condiciones experimentales: grupo de intervención (SSL) y grupo control (GC). Las evaluaciones se realizaron antes y después de la intervención de 8 semanas. Resultados: las ecuaciones de estimación generalizadas mostraron que, en comparación con el GC, la intervención redujo significativamente los síntomas emocionales de ansiedad y depresión. También se encontraron mejorías significativas en síntomas de trastornos de ansiedad específicos y en la interferencia de la ansiedad en la vida del niño. Conclusiones: los resultados de este estudio proporcionan apoyo inicial a los efectos inmediatos de SSL, sugiriendo que es un recurso valioso para la reducción temprana de los síntomas de ansiedad y depresión en niños pequeños hispanohablantes


Assuntos
Humanos , Masculino , Feminino , Criança , Ansiedade/prevenção & controle , Terapia Cognitivo-Comportamental/métodos , Depressão/prevenção & controle , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida , Transtornos de Ansiedade/prevenção & controle , Transtorno Depressivo/prevenção & controle , Pais , Instituições Acadêmicas , Autorrelato , Espanha , Listas de Espera
13.
Hu Li Za Zhi ; 66(4): 29-39, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31342499

RESUMO

BACKGROUND: Taiwan has the highest incidence and prevalence of dialysis in the world. The literature suggests that severity of depression at the beginning of dialysis treatment is an independent predictor of survival. Depression significantly worsens the condition of chronic renal disease patients, with the adverse consequences of depression including increased mortality and hospitalization rates as well as poor compliance and quality of life. Given the importance of this problem, providing safe and effective information and good nursing care to dialysis patients is urgently needed. PURPOSE: The purpose of this study was to explore the effects of implementing health promotion education groups on self-perceived depression, hope, and quality of life in dialysis patients. METHODS: Dialysis patients who met the study criteria and had provided consent to participate in the health promotion education group were randomly assigned to either the treatment group (20 persons) or the control group (20 persons). In the control group, routine dialysis treatment and nursing care were maintained. In addition to receiving routine dialysis treatment and nursing care, the experimental group participated in health promotion education group activities for 90 minutes, twice a week for a total of 8 sessions. The quantitative data from both groups and the qualitative data analysis of the experimental group were used to assess the effects of the intervention. RESULTS: The results showed that the intervention had significantly improved self-perceived depression, hope, and quality of life in the experimental group. The participants indicated that the health promotion education group had helped them learn to adapt to their physical conditions, change their mindset, learn to regard happiness as the purpose of life, and maintain hope and increase mutual support in the face of difficulties. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study demonstrated that the cross-disciplinary integrated care provided through health promotion education groups is able to significantly improve depression, hope, and quality of life in dialysis patients. Thus, health promotion education groups arranged by the case management nurses for dialysis patients have the potential to promote mental health and quality of life in these patients. Therefore, continuing education is recommended to strengthen the awareness and knowledge of dialysis case management nurses with regard to applying integrated cross-disciplinary care in health promotion education groups and to promoting the implementation of these groups in the holistic care of dialysis patients.


Assuntos
Depressão/prevenção & controle , Processos Grupais , Promoção da Saúde/métodos , Esperança , Educação de Pacientes como Assunto/métodos , Qualidade de Vida , Diálise Renal/psicologia , Humanos , Diálise Renal/enfermagem , Taiwan
14.
J Youth Adolesc ; 48(9): 1668-1685, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31346924

RESUMO

Given the recent rise in adolescent mental health issues, many researchers have turned to school-based mental health programs as a way to reduce stress, anxiety, and depressive symptoms among large groups of adolescents. The purpose of the current systematic review and meta-analysis is to identify and evaluate the efficacy of school-based programming aimed at reducing internalizing mental health problems of adolescents. A total of 42 articles, including a total of 7310 adolescents, ages 11-18, met inclusion for the meta-analyses. Meta-analyses were completed for each of the three mental health outcomes (stress, depression, and anxiety) and meta-regression was used to determine the influence of type of program, program dose, sex, race, and age on program effectiveness. Overall, stress interventions did not reduce stress symptoms, although targeted interventions showed greater reductions in stress than universal programs. Overall, anxiety interventions significantly reduced anxiety symptoms, however higher doses may be necessary for universal programs. Lastly, depression interventions significantly reduced depressive symptoms, but this reduction was moderated by a combination of program type, dose, race, and age group. Although, school-based programs aimed at decreasing anxiety and depression were effective, these effects are not long-lasting. Interventions aimed at reducing stress were not effective, however very few programs targeted or included stress as an outcome variable. Implications for practice, policy and research are discussed.


Assuntos
Ansiedade/psicologia , Depressão/prevenção & controle , Prevenção Primária/organização & administração , Serviços de Saúde Escolar/organização & administração , Estresse Psicológico/prevenção & controle , Estudantes/psicologia , Adolescente , Ansiedade/prevenção & controle , Criança , Depressão/psicologia , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Estresse Psicológico/psicologia
15.
Psychiatr Pol ; 53(2): 277-292, 2019 Apr 30.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-31317958

RESUMO

This article presents recommendations of the Polish Psychiatric Association regarding approach to pregnancy loss and unsuccessful in vitro treatment of infertility. From the psychological perspective pregnancy loss and perinatal death are amongst the most stressful events in human life - carrying increased risk of developing affective, anxiety or post-traumatic stress disorders. Psychologists, physicians and the rest of the medical staff should provide integrated and individualized care which should be based on respect, empathy and expertise. The necessary phases of support for women experiencing pregnancy loss are: (1) physician providing exhaustive informational support regarding state of health, potential causes of fetal death, further approach and phases of induced labor of the fetus/pregnancy termination/procedure, (2) facilitating psychological consultation at any time and (3) providing exhaustive information on current legal standing (health insurance and labor law). Experiencing recurrent in vitro fertilization failures may result in the emotional consequences similar to those observed in miscarriages. The prolonged frustration may favor developing depressive symptoms and escalate pathological anxiety. We present basic recommendations for psychotherapy and pharmacotherapy in pregnancy loss and unsuccessful in vitro infertility treatment.


Assuntos
Depressão/psicologia , Guias de Prática Clínica como Assunto , Complicações na Gravidez/psicologia , Natimorto/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Aborto Espontâneo , Depressão/prevenção & controle , Feminino , Humanos , Polônia , Gravidez , Complicações na Gravidez/prevenção & controle , Sociedades Médicas , Transtornos de Estresse Pós-Traumáticos/prevenção & controle
16.
Psychiatr Pol ; 53(2): 359-370, 2019 Apr 30.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-31317963

RESUMO

OBJECTIVES: The aim of the study is to investigate the views of adolescents aged 16-19, attending public high schools in Warsaw, on effectiveness of suicide prevention. METHODS: The studied population covered adolescents aged 16-19 back in 2015 (M = 17.29; SD = 0.94). The respondents attended eight public high schools in Warsaw in eight different districts. The study group was representative. 1,439 respondents participated in the study - 821 girls (57.1%) and 592 boys (41.1%). PAPI method was used in the conducted study. The questionnaire consisted of 34 questions. RESULTS: In most cases respondents did not know whether there was an organized system of suicide prevention in Poland (42.0%), however, a large proportion of the respondents (39.7%) was aware of nonexistence of such a system in Poland. The respondents considered the activity of a school (46.7%), the Church (38.3%) and the police (55.9%) in the field of suicide prevention ineffective, the activity of health care institutions (47.7%) and the media (46.6%) hardly effective, while the family was considered effective (70.9%). Persons who perceive significant role of the Church in suicide prevention at the same time indicate considerable share of the family and a much lesser role of the remaining institutions. CONCLUSIONS: 1) More than . of studied adolescents realize that there is no integrated system of suicide prevention; 2) The family, according to high school students, plays the greatest role in preventing self-destructive behaviors; 3) There is a need of greater involvement of schools, the Church, the police, health care institutions and the media in education and raising adolescents' awareness in the field of self-destructive behaviors.`.


Assuntos
Comportamento do Adolescente/psicologia , Depressão/prevenção & controle , Promoção da Saúde/métodos , Estudantes/psicologia , Suicídio/prevenção & controle , Adolescente , Depressão/epidemiologia , Feminino , Humanos , Masculino , Grupo Associado , Polônia , Estudantes/estatística & dados numéricos , Suicídio/psicologia , Adulto Jovem
17.
BMC Health Serv Res ; 19(1): 484, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31299968

RESUMO

BACKGROUND: Depression and anxiety are two of the leading causes of disease burden in low-to-middle income coutnries. The World Health Organisation has engaged in a programme of scaling-up mental health services, but significant challenges remain. Improving mental health literacy in children and young people, a core part of recent, global health strategies has the potential to address some of these challenges. The study aims to co-develop and feasibility test, a culturally-appropriate toolkit to promote depression and anxiety focused mental health literacy and self-management skills in Indonesia, for children aged 11-15 years. METHODS: A mixed methods study comprising four phases. Through a systematic review of existing evidence, phase 1 will review approaches to improve mental health literacy and self-management in South East Asia and critically review current evidence regarding intervention effect. Phase 2 will explore stakeholders' views on depression, anxiety and mental health more broadly and identify priorities for the intervention through the use of semi-structured interviews and/or focus groups with policy makers, clinicians, teachers, adolescent service users, carers and young people aged 11-15. Phase 3 will comprise iterative workshops with local stakeholders to present our findings and co-produce a testable, culturally appropriate toolkit to promote mental health literacy and depression/anxiety focused self-management in 11-15 year olds in Java, Indonesia. Phase 4 comprises feasibility evaluation of our developed intervention via nine in-depth case studies (Jakarta, Bogor and Magelang). We will examine the impact, acceptability and feasibility of our prototype intervention and produce evidence-based guidelines for wider implementation. DISCUSSION: Tools to support mental health literacy and self-management are a low cost way in which mental health services in LMICs can attempt to address the burden of anxiety and depression amongst children and young people. However, this is an underexplored area in Indonesia. Working closely with local stakeholders, this study will design and undertake feasibility evaluation of co-produced mental health literacy and anxiety and depression focussed interactive self-management tools. This abstract has also been published on the funders website (UK Research and Innovation. Improving Mental Health Literacy Among Young People aged 12-15 years in Indonesia 2019).


Assuntos
Alfabetização em Saúde/estatística & dados numéricos , Serviços de Saúde Mental/organização & administração , Saúde Mental , Adolescente , Ansiedade/prevenção & controle , Criança , Competência Cultural , Depressão/prevenção & controle , Estudos de Viabilidade , Feminino , Grupos Focais , Humanos , Indonésia , Masculino , Projetos de Pesquisa , Autogestão
18.
Psicothema ; 31(3): 298-304, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31292045

RESUMO

BACKGROUND: Super Skills for Life (SSL) is a transdiagnostic prevention program designed for children with anxiety and depressive symptoms based on cognitive-behavioral therapy. This study is a trial of the efficacy of the SSL program to reduce anxiety and depression symptoms in a representative sample of Spanish children aged 6 to 8. METHOD: This cluster randomized controlled trial involved 123 Spanish-speaking children recruited from 10 schools. Schools were the unit of randomization, and were randomly assigned to one of two experimental conditions: intervention group (SSL) and waiting list control (WLC) group. Assessments were conducted before and after the 8-week intervention. RESULTS: Generalized estimating equations showed that, compared with WLC, the intervention significantly reduced emotional symptoms of anxiety and depression. Significant improvements were also found in specific symptoms of anxiety disorders, and in the interference of anxiety in the child´s life. CONCLUSIONS: The findings of this study provide initial support for the immediate effects of SSL, suggesting that it is a valuable resource for the early reduction of anxiety and depressive symptoms in young Spanish-speaking children.


Assuntos
Ansiedade/prevenção & controle , Terapia Cognitivo-Comportamental/métodos , Depressão/prevenção & controle , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida , Transtornos de Ansiedade/prevenção & controle , Criança , Transtorno Depressivo/prevenção & controle , Feminino , Humanos , Masculino , Pais , Instituições Acadêmicas , Autorrelato , Espanha , Listas de Espera
19.
Eur Arch Otorhinolaryngol ; 276(10): 2827-2833, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31325032

RESUMO

PURPOSE: The effects of nasal obstruction in patients with chronic rhinosinusitis (CRS) are associated with depressed mood. We sought to validate this finding by determining whether improvement in nasal obstruction would translate to improvement in depressed mood. METHODS: This was a prospective observational study of 150 patients undergoing medical management for CRS. Data were collected at two timepoints: enrollment and a subsequent follow-up visit 3-12 months later. Impact of nasal obstruction was measured using the Nasal Obstruction Symptom Evaluation (NOSE) instrument and depressed mood was measured using the 2-item Patient Health Questionnaire (PHQ-2). Sinonasal symptoms associated with CRS were also measured using the 22-item Sinonasal Outcome Test (SNOT-22). Clinical and demographic characteristics were collected. The relationship between changes in PHQ-2 and NOSE scores was determined with correlation and linear regression. RESULTS: Change in PHQ-2 score was significantly correlated with change in NOSE score (ρ = 0.30, p < 0.001). After controlling for covariates, change in PHQ-2 score was associated with change in NOSE score (adjusted linear regression coefficient [ß] = 0.014, 95% CI 0.006-0.022, p = 0.001). We confirmed these relationships, finding that change in PHQ-2 was associated (adjusted ß = 0.037, 95% CI 0.013-0.061, p = 0.003) with change in the nasal subdomain score of the SNOT-22. Improvement in NOSE score by greater than 22 points was predictive of improvement in PHQ-2 score with sensitivity 54.5% and 83.8% specificity (p < 0.001). CONCLUSION: These results provide evidence that improvements in nasal manifestations/symptoms of CRS translate to significant improvements in mood.


Assuntos
Depressão , Obstrução Nasal , Rinite , Sinusite , Doença Crônica , Depressão/etiologia , Depressão/fisiopatologia , Depressão/prevenção & controle , Feminino , Humanos , Masculino , Conduta do Tratamento Medicamentoso , Pessoa de Meia-Idade , Obstrução Nasal/tratamento farmacológico , Obstrução Nasal/etiologia , Obstrução Nasal/psicologia , Medidas de Resultados Relatados pelo Paciente , Estudos Prospectivos , Rinite/complicações , Rinite/fisiopatologia , Sinusite/complicações , Sinusite/fisiopatologia , Avaliação de Sintomas/métodos , Estados Unidos
20.
Public Health ; 174: 1-10, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31265974

RESUMO

OBJECTIVES: Nursing students report high levels of anxiety and depression, which requires urgent attention. A growing amount of evidence indicates that self-compassion may indirectly (through perceived stress) and directly influence anxiety and depression, yet the research to date has not fully examined the reasons for this association. The present study examines the effects of self-compassion on anxiety and depression through perceived stress and may thus provide an innovative starting point for developing effective interventions for affected nursing students. STUDY DESIGN: This is a cross-sectional study. METHODS: Using structural equation modelling (SEM), we estimated the strength of the pathways between self-compassion, perceived stress and anxiety and depression among 1453 nursing students in Ningbo, China. The measurements included demographics, the Self-Compassion Scale-Short Form, the Chinese version of the Perceived Stress Questionnaire and the Goldberg Anxiety and Depression Scale. RESULTS: Nursing students had an average score of 4.50 ± 2.44 on the Goldberg Anxiety Scale (GAS) and 3.58 ± 2.34 on the Goldberg Depression Scale (GDS), indicating high levels of anxiety and depression. The GAS and GDS scores were significantly different by the academic year, part-time employment and career prospects. The average scores for self-compassion and perceived stress were 38.99 ± 4.55 and 0.40 ± 0.14, respectively. The SEM results suggested that self-compassion was negatively associated with anxiety and depression (-0.44, P < 0.001). Perceived stress was positively associated with anxiety and depression (0.64, P < 0.001). Self-compassion was negatively associated with perceived stress (-0.65, P < 0.001). Self-compassion had no significant correlation with anxiety and depression in the effect of perceived stress (-0.14, P = 0.127). Thus, self-compassion indirectly influences anxiety and depression through perceived stress. CONCLUSIONS: Self-compassion might reduce nursing students' anxiety and depression through perceived stress. Interventionists can consider using self-compassion training to alleviate perceived stress, anxiety and depression in nursing students.


Assuntos
Ansiedade/prevenção & controle , Depressão/prevenção & controle , Empatia , Autoimagem , Estudantes de Enfermagem/psicologia , Adolescente , Ansiedade/epidemiologia , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Estresse Psicológico/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
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