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1.
Medicine (Baltimore) ; 98(38): e17184, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567960

RESUMO

Although both multiple sclerosis (MS) and neuromyelitis optica (NMO) are demyelinating diseases, their psychiatric disturbances may differ given differences in the neurological manifestations. We used subjective and objective measurements to compare the psychiatric disturbances in patients with MS and NMO.Psychiatric disturbances were assessed in 24 MS and 35 NMO patients using the Beck Hopelessness Scale, Symptom Checklist-95 and the brief version of World Health Organization Quality of Life. Personality was assessed using the Big Five Inventory-10. Disease-related function was assessed using the Fatigue Severity Scale, Short-Form McGill Pain Questionnaire, and the Global Assessment of Function. Positivity offset (PO) and negativity bias (NB) and heart rate variability (HRV) were measured using a modified implicit affect test and photoplethysmograph, respectively. Data were analyzed using analysis of covariance with age and sex as covariates.MS patients had higher levels of depression, anxiety, panic attacks, obsessive-compulsiveness, aggression, paranoia, interpersonal sensitivity, self-regulation problems, stress vulnerability, and lower psychological quality of life (QOL) compared with NMO patients. The PO and NB and HRV values were not significantly different between groups. However, NMO patients had lower QOL, and higher levels of hopelessness, suicidality, and fatigue than the normal range. Disease duration was associated with hopelessness in NMO patients and with several psychiatric disturbances, but not hopelessness, in MS patients.Subjective psychiatric disturbances were more severe in patients with MS than in those with NMO, whereas PO and NB and HRV in patients with NMO were comparable with those of MS patients. Our findings highlight the need for different clinical approaches to assess and treat psychiatric disturbances in patients with MS and NMO.


Assuntos
Transtornos Mentais/etiologia , Esclerose Múltipla/psicologia , Neuromielite Óptica/psicologia , Adulto , Ansiedade/etiologia , Depressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Neuromielite Óptica/complicações , Transtorno Obsessivo-Compulsivo/etiologia , Transtorno de Pânico/etiologia , Transtornos Paranoides/etiologia , Escalas de Graduação Psiquiátrica , Qualidade de Vida/psicologia , Estresse Psicológico/etiologia
2.
Rev Lat Am Enfermagem ; 27: e3191, 2019.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-31596421

RESUMO

OBJECTIVE: to evaluate the impact on the quality of life as well as anxiety and pain in patients with nephrostomy tubes. METHOD: this is a longitudinal descriptive study performed on a sample of n=150 patients. To evaluate the quality of life, the EuroQol-5D questionnaire was used; anxiety was quantified by the Beck Anxiety Inventory; to study pain, a visual analogue scale was employed. RESULTS: statistically significant differences were found in the quality of life, with its worsening (r = 0.51; p <0.01) when evaluated at the first tube replacement. Patients presented mild to moderate anxiety before the procedure, which was reduced at the first tube replacement, although this difference was not significant (r = 0.028, p = 0.393). Finally, the degree of pain was also significantly reduced (r = 0.13, p<0.01) after six weeks. As for gender, women presented the worst values ​​in the three variables studied (worse quality of life and greater anxiety and pain). CONCLUSIONS: nephrostomy tubes have a negative impact on the patient's quality of life. During the time they live with these tubes, patients have mild to moderate pain and anxiety.


Assuntos
Transtornos de Ansiedade/psicologia , Nefrostomia Percutânea/efeitos adversos , Dor/etiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Nefrostomia Percutânea/enfermagem , Nefrostomia Percutânea/psicologia , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Inquéritos e Questionários
3.
An Bras Dermatol ; 94(4): 422-428, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644614

RESUMO

BACKGROUND: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa. OBJECTIVE: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates. METHODS: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20. RESULTS: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001). STUDY LIMITATIONS: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings. CONCLUSION: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.


Assuntos
Ansiedade/epidemiologia , Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Depressão/epidemiologia , Dermatopatias/epidemiologia , Dermatopatias/psicologia , Adolescente , Adulto , Distribuição por Idade , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Distribuição por Sexo , Fatores Socioeconômicos , Estatísticas não Paramétricas , Escala de Ansiedade Frente a Teste , Fatores de Tempo , Adulto Jovem
5.
N Engl J Med ; 381(10): 903-911, 2019 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-31483961

RESUMO

BACKGROUND: Altered neurotransmission of γ-aminobutyric acid (GABA) has been implicated in the pathogenesis of depression. Whether SAGE-217, an oral, positive allosteric modulator of GABA type A receptors, is effective and safe for the treatment of major depressive disorder is unknown. METHODS: In this double-blind, phase 2 trial, we enrolled patients with major depression and randomly assigned them in a 1:1 ratio to receive 30 mg of SAGE-217 or placebo once daily. The primary end point was the change from baseline to day 15 in the score on the 17-item Hamilton Depression Rating Scale (HAM-D; scores range from 0 to 52, with higher scores indicating more severe depression). Secondary efficacy end points, which were assessed on days 2 through 8 and on days 15, 21, 28, 35, and 42, included changes from baseline in scores on additional depression and anxiety scales, a reduction from baseline of more than 50% in the HAM-D score, a HAM-D score of 7 or lower, and a Clinical Global Impression of Improvement score of 1 (very much improved) or 2 (much improved) (on a scale of 1 to 7, with a score of 7 indicating that symptoms are very much worse). RESULTS: A total of 89 patients underwent randomization: 45 patients were assigned to the SAGE-217 group, and 44 to the placebo group. The mean baseline HAM-D score was 25.2 in the SAGE-217 group and 25.7 in the placebo group. The least-squares mean (±SE) change in the HAM-D score from baseline to day 15 was -17.4±1.3 points in the SAGE-217 group and -10.3±1.3 points in the placebo group (least-squares mean difference in change, -7.0 points; 95% confidence interval, -10.2 to -3.9; P<0.001). The differences in secondary end points were generally in the same direction as those of the primary end point. There were no serious adverse events. The most common adverse events in the SAGE-217 group were headache, dizziness, nausea, and somnolence. CONCLUSIONS: Administration of SAGE-217 daily for 14 days resulted in a reduction in depressive symptoms at day 15. Adverse events were more common in the SAGE-217 group than in the placebo group. Further trials are needed to determine the durability and safety of SAGE-217 in major depressive disorder and to compare SAGE-217 with available treatments. (Funded by Sage Therapeutics; ClinicalTrials.gov number, NCT03000530.).


Assuntos
Antidepressivos/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Moduladores GABAérgicos/uso terapêutico , Receptores de GABA-A/metabolismo , Administração Oral , Adulto , Regulação Alostérica , Antidepressivos/efeitos adversos , Transtorno Depressivo Maior/classificação , Tontura/induzido quimicamente , Método Duplo-Cego , Feminino , Moduladores GABAérgicos/efeitos adversos , Humanos , Análise dos Mínimos Quadrados , Masculino , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Escalas de Graduação Psiquiátrica
6.
Isr Med Assoc J ; 21(7): 449-453, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31507119

RESUMO

BACKGROUND: Fibromyalgia is a syndrome of unknown etiology that is characterized by widespread pain, which severely impairs quality of life. Several forms of occupational and alternative therapy have demonstrated beneficial effects in fibromyalgia patients. OBJECTIVES: To assess the effects of participation in a floral design course on physical and psychiatric symptoms in a cohort of fibromyalgia patients. METHODS: This study was conducted as an observational study. Women diagnosed with fibromyalgia over the age of 18 were recruited to participate in one of two 12-week flower design (floristry) courses. Demographic details, disease activity indices, and anxiety and depression scores were calculated for all participants at baseline, week 12, and study completion. Physical and mental health of the two groups were compared throughout the study time-points. RESULTS: The study was completed by 61 female fibromyalgia patients who were included in the final analyses; 31 patients participated in the first floristry course and 30 in the second. Significant improvements in the 36-Item Short Form Survey physical and mental health components, visual analog scale, Fibromyalgia Impact Questionnaire, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale scores for the entire study population and for each group separately could be seen following participation in each floristry course. CONCLUSIONS: Participation in a floristry course may lead to a significant improvement in pain and psychiatric symptoms in fibromyalgia patients. These findings highlight the potential benefit of utilizing occupational therapy programs, such as a floristry course, for improving quality of life in fibromyalgia.


Assuntos
Ansiedade/terapia , Terapias Complementares/métodos , Depressão/terapia , Fibromialgia/terapia , Qualidade de Vida , Adulto , Idoso , Ansiedade/psicologia , Estudos de Coortes , Depressão/psicologia , Feminino , Fibromialgia/fisiopatologia , Fibromialgia/psicologia , Flores , Humanos , Pessoa de Meia-Idade , Medição da Dor , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários
8.
Psychiatr Danub ; 31(Suppl 3): 237-241, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488733

RESUMO

BACKGROUND: In a two-year study, we compared the efficacy of noradrenergic and serotonergic antidepressants with and without the addition of 100 mg acetylsalicylic acid (ASA) in subjects suffering from major depressive disorder (MDD). In this article we examine the influence of the health locus of control, family relationships and personality traits on the progress of MDD. SUBJECTS AND METHODS: 40 people with MDD (MDD group) were randomly assigned to the different treatment groups. They were followed in parallel with a group of 20 'healthy' subjects (HG). At the beginning of the study, sociodemographic data were collected, and patients were asked to complete the Multidimensional Health Locus of Control (MHLC) scale, the NEO Five-Factor Inventory (NEO-FFI), and the Family Adaptation and Cohesion Scale (FACES III). During the study subjects were regularly assessed using the Hamilton Depression Scale (HDS), the Short Form Health Survey (SF-12) and the Clinical Global Impression scale (CGI). RESULTS: Regardless of the type of treatment, physical health is the best predictor of variation at two years in the MDD group; 45% of variance is explained by a linear regression model that includes three variables from the MHLC, FACES III and NEO-FFI scales. Similarly, 40% of CGI and 24% of HDS variance is predicted. These explanatory variables are statistically less powerful in the MDD group than the HG group. CONCLUSION: While drug treatment is a determinant in changes on the HDS, CGI and SF12 scales, factors such as family relationships, MHLC or personality are important covariates of these changes. The question remains whether we can influence these covariates to improve the response to antidepressants.


Assuntos
Antidepressivos/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/psicologia , Relações Familiares , Controle Interno-Externo , Humanos , Escalas de Graduação Psiquiátrica
9.
Rev Lat Am Enfermagem ; 27: e3168, 2019 Aug 19.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31432921

RESUMO

OBJECTIVE: to identify the frequency of fatigue and domains affected in patients with head and neck cancer undergoing radiation therapy, at the beginning, middle and end of treatment. METHOD: longitudinal and prospective study of quasi-experimental design, involving 60 patients with head and neck cancer. It should be highlighted that this article will address only the data of the Control Group. The dependent variables were collected through interview, using the revised Piper Fatigue Scale, which is a multidimensional instrument that assesses global, behavioral, affective and sensory/psychological domains. Data analysis was based on absolute and relative frequencies. RESULTS: there was a predominance of males, age group between 41-60 years, low level of education and in regular use of alcohol and cigarettes. All domains in the fatigue scale had their scores increased, presenting median values of greater magnitude in Time 2 and Time 3, when compared to the Time 1 values, indicating an increase in fatigue levels during radiation therapy. CONCLUSION: fatigue increased in the course of the radiation therapy, having all domains affected. Therefore, its evaluation throughout the treatment is important, as fatigue is a common and debilitating symptom on cancer patients.


Assuntos
Carcinoma de Células Escamosas/radioterapia , Fadiga/etiologia , Neoplasias de Cabeça e Pescoço/radioterapia , Radioterapia/efeitos adversos , Adulto , Brasil , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/psicologia , Fadiga/psicologia , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Radioterapia/psicologia , Fatores Socioeconômicos , Inquéritos e Questionários
10.
Medicine (Baltimore) ; 98(31): e16674, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374046

RESUMO

BACKGROUND AND OBJECTIVE: A recent striking advance in the treatment of depression has been the finding of rapid antidepressant effects in over 70% of patients with treatment-resistant depression (TRD) using ketamine. However, the potential risk of addiction may limit its clinical use. Recent research revealed that blockade of N-methyl-D-aspartate receptor (NMDAR) dependent bursting activity in the lateral habenula (LHb) could mediate the fast antidepressant effects of ketamine. Further, LHb bursting plays an important role in the pathophysiology of depression that requires both NMDARs and low-voltage-sensitive T-type calcium channels (T-VSCCs). Ethosuximide, which is used to treat absence seizures, is a T-VSCCs inhibitor, may be a novel drug candidate for depression. The objective of this clinical trial is to investigate the efficacy and safety of ethosuximide in patients with TRD. DESIGN: The study is a single center, randomized, double-blind, placebo-controlled, parallel-group, two-stage clinical trial. Forty patients with TRD will be randomly assigned to Group A (treatment group) or Group B (control group). In the first stage ethosuximide or placebo will be given for 2 weeks. In the second stage, escitalopram (or another antidepressant if escitalopram has been used before) will be given for the next 4 weeks for all trial patients to ensure effective treatment. The primary outcome measure is the Montgomery-Åsberg Depression Rating Scale (MADRS) scores. Secondary outcome measures include the Quick Inventory of Depressive Symptomatology-Self Report score, Hamilton Anxiety Rating Scale scores, individual scores of MADRS, and Young Mania Rating Scale scores. All these scales are measured at baseline and at each treatment visit. Two-way repeated measures analysis of variance is used to analyze the study outcomes. DISCUSSION: A statistical analysis plan is employed to enhance the transparency of the clinical trial and reduce the risks of outcome reporting bias and data-driven results.


Assuntos
Antidepressivos/uso terapêutico , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológico , Etossuximida/uso terapêutico , Método Duplo-Cego , Etossuximida/farmacologia , Humanos , Escalas de Graduação Psiquiátrica , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
11.
Pan Afr Med J ; 33: 27, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384342

RESUMO

Introduction: In Nigeria, approximately 4.33 million adults suffer from hypertension and about a third of them do not adhere to prescribed medications. Depression has been reported to significantly predict poor medication adherence. The relationship between medication non-adherence and co-morbid depressive disorder in patients with hypertension has not been adequately explored in this environment. The study aimed to determine the prevalence of depression in patients with hypertension. The association between socio-demographic characteristics and presence of co-morbidity on medication adherence was also determined. Methods: A cross-sectional descriptive research design was adopted for the study. A socio-demographic questionnaire, the modified Morisky Medication Adherence Scale (MMAS), the Hamilton Rating Scale for Depression (HAM-D) and the Mini International Neuropsychiatric Interview (MINI), were administered to four hundred patients with hypertension attending medical out-patient clinic between August and September 2012. Results: About 43% (168) were aged 61 to 64 years the majority being females, with a female to male ratio of 1.63:1. The prevalence of comorbid depression was 22.8%, made up of mild (21.8%) and moderate (1.0%) depressive episodes only. Depression was commoner among females than males in a ratio of 3:1. A majority of the participants (96.8%) had high medication adherence; 2.8% and 0.4% had moderate and low adherence respectively. Depression was more among patients with good medication adherence. Conclusion: The occurrence of mild depressive disorder among hypertensives did not affect the level of medication adherence. Review of Antihypertensive drugs should also be done often to ensure patients are not likely to have depressive illness as a side effect of drugs used.


Assuntos
Anti-Hipertensivos/administração & dosagem , Depressão/epidemiologia , Hipertensão/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Adulto , Anti-Hipertensivos/efeitos adversos , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Nigéria , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Fatores Sexuais , Inquéritos e Questionários , Centros de Atenção Terciária , Adulto Jovem
12.
Braz J Cardiovasc Surg ; 34(4): 389-395, 2019 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-31364347

RESUMO

OBJECTIVE: The aim of this clinical study is to determine the depression and anxiety levels in coronary artery bypass graft (CABG) surgery patients in the pre and postoperative periods. METHODS: This clinical prospective study was done with 65 patients. Beck's Depression Inventory (BDI) and Beck's Anxiety Inventory (BAI) tests were performed in patients who had a diagnosis of coronary artery disease and were awaiting CABG surgery. These patients presented characteristic symptoms of anxiety and depression and BDI and BAI tests are important to assess these symptoms. RESULTS: We found out that depression and anxiety levels were higher in the postoperative than in the preoperative period (P<0.001). Both anxiety and depression levels were increased significantly following CABG operation when compared with preoperative levels in all patients. Statistical correlation of depression and anxiety in different ages, genders, and professions were evaluated too, but we did not found a correlation between them (P>0.05). CONCLUSION: We suggest that good management of the psychological condition of cardiac surgery candidates, as well as post-bypass patients, will improve quality of life and cardiovascular outcomes in these patients.


Assuntos
Ansiedade/psicologia , Ponte de Artéria Coronária/psicologia , Depressão/psicologia , Distribuição por Idade , Idoso , Ansiedade/cirurgia , Depressão/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Distribuição por Sexo
13.
Health Qual Life Outcomes ; 17(1): 139, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412878

RESUMO

PURPOSE: The study of mental wellbeing requires reliable, valid, and practical measurement tools. One of the most widely used measures of mental wellbeing is the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Our aim was to examine the psychometric properties of SWEMWBS (a brief seven-item version) in a 'real-world' population sample of young people. METHODS: We used data from the 2017 School Health Research Network Student Health and Wellbeing Survey, completed by 103,971 students in years 7 to 11 from 193 secondary schools in Wales. We first estimated polychoric correlation matrices for the whole sample and by school year, and undertook a principal components analysis to check for configural invariance. Subsequently, we used a multiple-groups structural equation model with successively greater constraints to test measurement invariance. To examine external construct validity, we calculated correlations between the SWEMWBS score and four covariates: life satisfaction, somatisation, school pressure and bullying victimisation. RESULTS: Parallel analysis suggested that extraction of one factor was appropriate both overall and in each year group. Inspection of standardised loadings suggested that four items had progressively stronger correlations with the factor as students are older, but change in fit indices between models suggested that loadings and thresholds, but not residual variances, were invariant by age group. SWEMWBS scores were moderately correlated with measures of life satisfaction and somatisation, and weakly to moderately correlated with school pressure and bullying victimisation. CONCLUSIONS: This study adds to the growing evidence that SWEMWBS is appropriate for measuring mental wellbeing in young people and suggests that SWEMWBS is appropriate for tracking the development of wellbeing across adolescence.


Assuntos
Escalas de Graduação Psiquiátrica/normas , Qualidade de Vida/psicologia , Estudantes/psicologia , Adolescente , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Satisfação Pessoal , Análise de Componente Principal , Psicometria , Reprodutibilidade dos Testes , País de Gales , Adulto Jovem
14.
Pan Afr Med J ; 32: 204, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31312316

RESUMO

Background: Suicidal behaviors are increasing in Tunisia at younger and younger ages. This study aims to describe the sociodemographic and clinical profile of suicide attempts in children and adolescents. Methods: We conducted a cross-sectional and descriptive study, including 50 suicidal individuals, recruited in the Child Psychiatry Department at the Razi Hospital in Manouba and in two Departments in Tunisia (Intensive Care and Reanimation Department and Department of Pediatrics) between July 2012 and June 2013. We identified the socio-demographic and clinical factors, the histories of abuse, subjects' education, the characteristics of the attempted suicides (TS), suicidal ideation assessed by the Suicidal Intent Scale and psychopathological disorders diagnosed using the Mini-International Neuropsychiatric Interview. Results: The sex-ratio was 0.56, the average age was 12.4 years ranging from 7 to 16 years. School failure or dropout were found in 86% of suicidal individuals. In 38% of cases suicidal behavior was recurrent; the subjects had a history of self-mutilation to the same extent. A context of abuse was reported in 46% of cases. Drug ingestion was the most common means of suicide, psychotropic drugs were the most common substances used. There was a significant gender difference in the use of the means of suicide: the boys mainly used physical means (P=0.04) while the girls poisoning (P=0.001). Suicidal intent was high in 44% of cases. A major depressive episode and adjustment disorder were the most common disorders found (58% and 24% of cases respectively). Conclusion: Depressive disorders and abuse are risk factors of TS in children and adolescents, these factors should be considered when implementing suicide prevention strategies for this population.


Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Transtornos de Adaptação/epidemiologia , Adolescente , Criança , Estudos Transversais , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Psicotrópicos/administração & dosagem , Recidiva , Fatores de Risco , Comportamento Autodestrutivo/epidemiologia , Fatores Sexuais , Tentativa de Suicídio/psicologia , Tunísia/epidemiologia
15.
Medicine (Baltimore) ; 98(27): e16274, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277153

RESUMO

This study aimed to investigate the recognition rate of psychological distress in general hospitals in China and to examine the main associated factors.Using a cross-sectional study design, the questionnaires were administered to a total of 1329 inpatients from a tertiary hospital. The Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder 7-item scale (GAD-7), the Patient Health Questionnaire (PHQ-15) and the Whiteley-7 (WI-7) were used to assess patients' mental health status. Two subjective questions were used to identify the awareness of psychological distress in patients and doctors.The frequency of psychological distress measured by the questionnaires was high in our sample (53.4%). However, the recognition rates of both patients (34.9%) and by doctors (39.1%) was low. The concordance rate between patients and doctors of whether the patient had psychological distress or not was extremely poor (Kappa = 0.089, P = .001). Factors associated with the poor concordance rate included patients' annual household income and clinically significant self-reported symptoms of anxiety and hypochondriasis.The recognition rate of psychological distress was underestimated and this may be related to a lack of awareness of mental disturbances and patients' low annual household income.


Assuntos
Ansiedade/epidemiologia , Hospitais Gerais/estatística & dados numéricos , Médicos/psicologia , Qualidade de Vida , Estresse Psicológico/epidemiologia , Carga de Trabalho/psicologia , Adulto , Idoso , Ansiedade/etiologia , Ansiedade/psicologia , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Fatores Socioeconômicos , Estresse Psicológico/complicações , Inquéritos e Questionários
16.
Nord J Psychiatry ; 73(6): 349-356, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31271338

RESUMO

Background: Treatment satisfaction predicts treatment adherence and long-term outcome for patients with psychosis. It is therefore important to understand the underpinnings of patient satisfaction in psychosis treatment for optimal treatment delivery. Aims: To examine the associations between satisfaction and level and change in positive symptoms, insight, depression and side effects of antipsychotics in previously medicated and antipsychotic-naïve patients. Method: Data derive from a randomised trial, with 226 respondents at baseline and 104 at follow-up. The measures were the positive subscale and insight item from the Positive and Negative Syndrome Scale, Calgary Depression Scale, the UKU Consumer Satisfaction Rating Scale, and the UKU side effects scale. Structural equation modelling was used to test the model. The full information maximum likelihood estimator used all available data. Results: In the sample of 226 patients, 67.3% were male and 44.2% were antipsychotic-naïve. The mean age was 34.1 years. For previously medicated patients, satisfaction was predicted by level of insight (b = -2.21, ß = -0.42) and reduction in positive symptoms (b = -0.56, ß = -0.39). For antipsychotic-naïve patients, satisfaction was predicted by level and change of insight (b = -2.21, ß = -0.46), change in depression (b = -0.37, ß = -0.26) and side effects (b = -0.15, ß = -0.30). All predictors were significant at the 0.05 level. Conclusion: Reducing positive symptoms and side effects are important to enhance patient satisfaction. However, improving insight and reducing depression are more important in antipsychotic-naïve patients.


Assuntos
Antipsicóticos/uso terapêutico , Satisfação do Paciente , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/psicologia , Doença Aguda/psicologia , Doença Aguda/terapia , Adulto , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Ensaios Clínicos Controlados Aleatórios como Assunto
17.
Nord J Psychiatry ; 73(6): 309-316, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31304872

RESUMO

Background: The aim of this study was to describe personality traits in psychiatric patients and to investigate whether these traits are stable over 13 years. Methods: A total of 95 individuals who were patients at a psychiatric outpatients' clinic in 2003 completed the Swedish universities Scales of Personality (SSP). Scores from 2003 were compared with SSP scores from 2016. Based on the current score on the comprehensive psychopathological rating scale - self rating for affective disorders (CPRS-S-A), the participants were divided into two groups representing 'good' and 'poor' current mental states, to investigate the effect of current mental state on reports of personality traits. Results: Out of 13 personality traits, 11 showed a significant change in mean T-score over the study interval. The group with lower CPRS-S-A scores showed a significant change in T-score for 10 traits, whereas in the group with higher CPRS-S-A scores only 3 traits showed a significant change. Conclusions: The findings support the theory that personality is changeable over the course of life, also in psychiatric patients. We do not know if persisting psychiatric symptoms halter change or if deviant personality traits cause psychiatric symptoms to continue.


Assuntos
Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Determinação da Personalidade , Personalidade , Adolescente , Adulto , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Suécia , Universidades , Adulto Jovem
18.
Nord J Psychiatry ; 73(6): 380-386, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31322453

RESUMO

Objective: In the present study, we compared social anxiety disorder (SAD) patients with (n = 31) and without childhood and adulthood separation anxiety disorder (SeAD) (n = 50) with respect to suicidal behavior, avoidant personality disorder (AvPD), other anxiety disorders (ADs), and major depression as well as some sociodemographic variables. Methods: In assessment of patients, we used Structured Clinical Interview for Separation Anxiety Symptoms, childhood and adulthood Separation Anxiety Symptom Inventories, Liebowitz Social Anxiety Scale, The SCID-II Avoidant Personality Disorder Module, Beck Depression Inventory, and Beck Scale for Suicidal Ideation. Results: SAD patients with SeAD had higher comorbidity rates of AvPD, other lifetime ADs and panic disorder, and current major depression than those without SeAD. The current scores of SAD, depression, and suicide ideation and the mean number of AvPD symptoms were significantly higher in comorbid group compared to pure SAD subjects. The SAD and SeAD scores had significant associations with current depression, suicide ideations, and AvPD. The mean number of AvPD criteria and the current severity of depression were significantly associated with the comorbidity between SAD and SeAD. Conclusion: Our findings might indicate that the comorbidity of SeAD with SAD may increase the risk of the severity of AvPD and current depression.


Assuntos
Ansiedade de Separação/complicações , Ansiedade de Separação/psicologia , Fobia Social/complicações , Fobia Social/psicologia , Adulto , Ansiedade de Separação/diagnóstico , Comorbidade , Depressão/diagnóstico , Depressão/psicologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/psicologia , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , Fobia Social/diagnóstico , Escalas de Graduação Psiquiátrica , Ideação Suicida
19.
Artigo em Russo | MEDLINE | ID: mdl-31317883

RESUMO

At the modern level of knowledge, classification of asthenic deficit as an independent psychopathological category and, in general terms, as the classification of asthenic symptomatic complexes of negative symptoms within schizophrenia and schizophrenia spectrum disorders is the subject of discussion. Studies of recent decades have shown that asthenia cannot be considered as a separate deficient monosyndrome, does not fit into the framework of negative disorders and is excluded from the block of scales of negative symptoms (SANS, PANSS, BNSS, CAINS). The authors suggest a working hypothesis that asthenia symptomatic complexes within schizophrenia are not comparable either in nature or in their psychopathological structure with primary deficiency disorders determined by the disease process. However, at the same time schizoasthenia, acting as a manifestation of the coenesthesiopathic hypochondriacal register, i.e. essentially in the space of positive disorders, is formed in close dependence on negative symptoms and is thus one of the markers of the already formed defect.


Assuntos
Esquizofrenia , Psicologia do Esquizofrênico , Astenia , Biomarcadores , Humanos , Escalas de Graduação Psiquiátrica , Psicopatologia
20.
Braz J Infect Dis ; 23(4): 224-230, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31344356

RESUMO

Human T-cell lymphotropic virus type 1 (HTLV-1) has low prevalence rates, but is endemic in some regions of the world. It is usually a chronic asymptomatic infection, but it can be associated with serious neurologic and urinary conditions. Hepatitis C virus (HCV) is broadly spread out worldwide. The majority of these infections have a chronic course that may progress to cirrhosis and hepatocellular carcinoma. OBJECTIVES: To compare sociodemographic and mental health (risk behaviors, depression, and suicide) aspects, and quality of life among patients with HCV or HTLV-1. METHODS: Observational, comparative and cross-sectional study involving outpatients with HCV or HLTV-1 infection. Sociodemographic characteristics, risk behaviors and quality of life were assessed through the questionnaires Mini International Neuropsychiatric Interview - MINI Plus (depression and suicide) and Medical Outcomes Study 36-Item Short-Form Health Survey (quality of life). Univariate and multivariate statistical analyses (hierarchical logistic regression) were conducted. RESULTS: 143 individuals with HCV and 113 individuals with HTLV-1 infection were included. Males were predominant in the HCV group (68.8%) and females in the HTLV-1 group (71.7%). The frequency of risk behaviors (sexual and drug use) was greater in those with HCV (p < 0.05). A past depressive episode was more common in the HTLV-1 group (p = 0.037). Quality of life was significantly worse in the physical functioning, vitality, mental health, and social functioning domains in those with HTLV-1 (p < 0.05). HTLV-1 infection remained independently associated with worse quality of life in multivariate analysis. CONCLUSIONS: Risk behaviors are frequent among those infected with HCV. Additionally, despite HTLV-1 being considered an infection with low morbidity, issues related to mental health (depressive episode) and decreased quality of life are relevant.


Assuntos
Depressão/virologia , Infecções por HTLV-I/psicologia , Hepatite C/psicologia , Qualidade de Vida/psicologia , Assunção de Riscos , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Análise Multivariada , Escalas de Graduação Psiquiátrica , Fatores de Risco , Comportamento Sexual , Estatísticas não Paramétricas , Ideação Suicida , Inquéritos e Questionários
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