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Arch. Clin. Psychiatry (Impr.) ; 47(1): 19-24, Jan.-Feb. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1088743


Abstract Background Sleep disorders are common in psychiatric diseases. Panic disorder (PD) and generalized anxiety disorder (GAD) are two major anxiety disorders that are associated with sleep disorders. Objective We hypothesized that poor sleep quality continues in PD and GAD during remission. Therefore, in this study we aimed to compare the sleep quality of patients with PD and GAD to that of healthy controls. Methods The study included patients with PD (n = 42) and GAD (n = 40) who had been in remission for at least 3 months and healthy control volunteers (n = 45). The patients were administered the Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). Results The total PSQI scores of the GAD group were significantly increased in comparison to those of the PD (p = 0.009) and control (p < 0.001) groups. The rate of poor sleep quality in GAD during remission (77.5%) was greater than that of the PD (47.6%) and control (51.1%) groups (p = 0.011). Discussion GAD is a chronic and recurrent disease. In this study, it was found that the deterioration in sleep quality of patients with GAD may continue during remission. In the follow-up and treatment of patients, it is appropriate to question about sleep symptoms and to plan interventions according to these symptoms.

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Transtornos de Ansiedade/complicações , Transtornos do Sono-Vigília/etiologia , Qualidade do Solo , Transtorno de Pânico/complicações , Transtornos de Ansiedade/tratamento farmacológico , Tabagismo/psicologia , Estudos de Casos e Controles , Estudos Transversais , Transtorno de Pânico/tratamento farmacológico , Inibidores de Captação de Serotonina/uso terapêutico , Intervalo Livre de Doença , Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico , Questionário de Saúde do Paciente
PLoS One ; 14(12): e0225609, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31846468


BACKGROUND: Alcohol is associated with depression among adolescents, but variations in the association by age and sex are relatively unexplored. This study aims to assess variations in the association between alcohol consumption and depressed mood among adolescents by age and sex. METHODS: We analyzed data from a school-based survey of 38,186 students in junior high school (Year 7 and 9) and senior high school (Year 11). The mean age of the participants was 15.2 (SD = 1.9) years. We used multivariate logistic regression to measure the association between self-reported alcohol drinking (past-year, past-month, and binge-drinking) and history of depressed mood for two weeks or more during the past year. We stratified the analyses by school level (as proxy for age group) and sex of the respondent. RESULTS: Approximately 1% of students in surveyed schools refused to answer the questionnaires and fewer than 5% of all questionnaires were invalid. Prevalence of depressed mood was 13.2%. Prevalence of past-year alcohol drinking was 41.0% among those with depressed mood vs. 24.6% among those with no depressed mood (Adj OR = 1.78, 95% CI = 1.60, 1.98). The association was strongest among girls in junior high school (Adj OR = 2.38, 95% CI = 2.03, 2.79) and weakest among boys in senior high school (Adj OR = 1.19, 95% CI = 0.99, 1.42). CONCLUSION: Associations between alcohol drinking and depressed mood were particularly strong among junior high school girls. Youth mental health and alcohol programs should consider prioritizing this sub-group accordingly.

Saúde do Adolescente , Transtorno Depressivo/epidemiologia , Saúde Mental , Estudantes/estatística & dados numéricos , Consumo de Álcool por Menores/estatística & dados numéricos , Adolescente , Afeto , Fatores Etários , Criança , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Questionário de Saúde do Paciente/estatística & dados numéricos , Prevalência , Instituições Acadêmicas/estatística & dados numéricos , Autorrelato/estatística & dados numéricos , Fatores Sexuais , Estudantes/psicologia , Tailândia/epidemiologia , Consumo de Álcool por Menores/prevenção & controle , Consumo de Álcool por Menores/psicologia
PLoS One ; 14(12): e0225540, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31851666


BACKGROUND: Current treatment options for chronic pain and depression are largely medication-based, which may cause adverse side effects. Integrative Medical Group Visits (IMGV) combines mindfulness techniques, evidence based integrative medicine, and medical group visits, and is a promising adjunct to medications, especially for diverse underserved patients who have limited access to non-pharmacological therapies. OBJECTIVE: Determine the effectiveness of IMGV compared to a Primary Care Provider (PCP) visit in patients with chronic pain and depression. DESIGN: 9-week single-blind randomized control trial with a 12-week maintenance phase (intervention-medical groups; control-primary care provider visit). SETTING: Academic tertiary safety-net hospital and 2 affiliated federally-qualified community health centers. PARTICIPANTS: 159 predominantly low income racially diverse adults with nonspecific chronic pain and depressive symptoms. INTERVENTIONS: IMGV intervention- 9 weekly 2.5 hour in person IMGV sessions, 12 weeks on-line platform access followed by a final IMGV at 21 weeks. MEASUREMENTS: Data collected at baseline, 9, and 21 weeks included primary outcomes depressive symptoms (Patient Health Questionnaire 9), pain (Brief Pain Inventory). Secondary outcomes included pain medication use and utilization. RESULTS: There were no differences in pain or depression at any time point. At 9 weeks, the IMGV group had fewer emergency department visits (RR 0.32, 95% CI: 0.12, 0.83) compared to controls. At 21 weeks, the IMGV group reported reduction in pain medication use (Odds Ratio: 0.42, CI: 0.18-0.98) compared to controls. LIMITATIONS: Absence of treatment assignment concealment for patients and disproportionate group attendance in IMGV. CONCLUSION: Results demonstrate that low-income racially diverse patients will attend medical group visits that focus on non-pharmacological techniques, however, in the attention to treat analysis there was no difference in average pain levels between the intervention and the control group. TRIAL REGISTRATION: NCT02262377.

Dor Crônica/terapia , Depressão/terapia , Medicina Integrativa/métodos , Atenção Plena/métodos , Visita a Consultório Médico , Centros Médicos Acadêmicos/organização & administração , Adulto , Idoso , Idoso de 80 Anos ou mais , Dor Crônica/diagnóstico , Dor Crônica/psicologia , Centros Comunitários de Saúde/organização & administração , Depressão/diagnóstico , Depressão/psicologia , Feminino , Humanos , Medicina Integrativa/organização & administração , Masculino , Pessoa de Meia-Idade , Medição da Dor , Questionário de Saúde do Paciente , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/organização & administração , Provedores de Redes de Segurança/organização & administração , Índice de Gravidade de Doença , Método Simples-Cego , Centros de Atenção Terciária/organização & administração , Resultado do Tratamento , Adulto Jovem
Tidsskr Nor Laegeforen ; 139(14)2019 Oct 08.
Artigo em Norueguês, Inglês | MEDLINE | ID: mdl-31592606


BACKGROUND: Depression and anxiety are common in patients with cardiac disease and predict a poorer prognosis, increased mortality and reduced compliance with treatment. National and international guidelines recommend procedures for screening, but there is a lack of studies of such practices in Norwegian hospitals. The objective of this study was to implement a simple screening method for symptoms of depression and anxiety in patients with cardiac disease. MATERIAL AND METHOD: Patients in the Department of Cardiology at Diakonhjemmet Hospital who had valvular heart disease, tachyarrhythmia, myocardial infarction or heart failure were screened for symptoms of depression, anxiety and panic attacks with the aid of five questions from the Patient Health Questionnaire-2 (PHQ-2), Generalized Anxiety Disorder Scale-2 (GAD-2) and Patient Health Questionnaire - Somatic, Anxiety, and Depressive Symptom Scales (PHQ-SADS). The patients were recruited from the outpatient clinic or ward at least one month after acute heart disease. RESULTS: A total of 57 of 232 patients reported symptoms of depression or anxiety when screened. The screening method was easy to implement, but time constraints and uncertainty regarding procedures for follow-up and the effect of following up the patients were reported. INTERPRETATION: Good tools and methods are available for screening for symptoms of depression and anxiety and anxiety in patients with cardiac disease. More studies are needed regarding the benefits of screening, at what stage of the disease it should be performed, and whether it should be performed by the primary and/or the specialist health services.

Ansiedade/diagnóstico , Serviço Hospitalar de Cardiologia , Depressão/diagnóstico , Cardiopatias/psicologia , Assistência ao Convalescente , Idoso , Idoso de 80 Anos ou mais , Feminino , Insuficiência Cardíaca/psicologia , Doenças das Valvas Cardíacas/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/psicologia , Noruega , Transtorno de Pânico/diagnóstico , Questionário de Saúde do Paciente , Taquicardia/psicologia
BMC Musculoskelet Disord ; 20(1): 439, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31597562


BACKGROUND: Chronic low back pain (LBP) is a leading cause of disability worldwide. Biopsychosocial rehabilitation programs have been advocated for its management, especially since the widespread acceptance of the biopsychosocial model of chronic pain. Despite extensive evidence of its short-term benefits, few studies have reported on its long-term effect and more specifically on indirect outcomes such as return to work and quality of life (QoL). The present study evaluated the long-term effect of a multidisciplinary biopsychosocial rehabilitation (MBR) program for patients with chronic LBP, for which short- and intermediate-term efficacy had been established, with an emphasis on recovering work capability. METHODS: This prospective cohort study enrolled 201 patients on a four-week MBR program incorporating physical and occupational therapies and psychological counselling. Assessments occurred at program admission and discharge and at 6 and 18 months. Work capability, Oswestry Disability Index, Tampa Scale for Kinesiophobia, Core Outcome Measures Index (COMI), and Hospital Anxiety and Depression Scale were assessed. Multiple mixed models were used to detect changes in each outcome. Logistic regressions were calculated to identify predictors of recovery of work capability. RESULTS: Of the 201 patients who fulfilled the eligibility criteria, 160 (79.8%) attended the discharge assessment, 127 (63.2%) attended the 6-month follow-up, and 107 (53.3%) continued to the 18-month follow-up. Initially, 128 patients (71.5%) had been on sick leave. At 6 and 18 months, 72 (56.7%) and 84 (78.5%) participants had recovered their work capability, respectively. There were significant improvements in pain, disability, kinesiophobia, and anxiety and depression scores over time. Patients who recovered work capability showed significantly greater improvements in their total COMI score, general QoL, and disability, which were the best three predictors of recovering work capability. CONCLUSIONS: This study extends previous results confirming the program's contribution to recovering work capability among chronic LBP patients.

Ansiedade/reabilitação , Dor Crônica/reabilitação , Depressão/reabilitação , Dor Lombar/reabilitação , Terapia Ocupacional/métodos , Reabilitação Psiquiátrica/métodos , Adulto , Ansiedade/diagnóstico , Ansiedade/etiologia , Dor Crônica/complicações , Dor Crônica/diagnóstico , Dor Crônica/psicologia , Terapia Combinada/métodos , Depressão/diagnóstico , Depressão/etiologia , Avaliação da Deficiência , Feminino , Seguimentos , Humanos , Dor Lombar/complicações , Dor Lombar/diagnóstico , Dor Lombar/psicologia , Masculino , Pessoa de Meia-Idade , Medição da Dor , Equipe de Assistência ao Paciente , Questionário de Saúde do Paciente , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento
Enferm. glob ; 18(56): 119-132, oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-188268


Objetivo: Evaluar el grado de deterioro de la calidad de vida de las personas con enfermedad de Hansen, de acuerdo con las variables sociodemográficas y clínicas Método: Estudio descriptivo, transversal, cuantitativo, que involucró a 45 pacientes de un hospital de referencia en João Pessoa, Paraíba, Brasil. Para la obtención de datos, las entrevistas se realizaron a partir de un cuestionario semiestructurado que incluyó las variables sociodemográficas y clínicas de los participantes; para evaluar su calidad de vida se utilizó el instrumento Dermatology Life Quality Index, luego de su aprobación en el Comité de Ética en Investigación de la Universidad Federal de Paraíba. En el análisis de los datos, se utilizó la Prueba no paramétrica del Qui-cuadrado de Pearson con un nivel de significación del 5% (p <0,05), usándose la continuidad de corrección de Yates, cuando fue necesario. Resultados: Se destaca la prevalencia de individuos varones, pardos, solteros, de entre 18 y 40 años, con ingresos familiares inferiores a tres salarios mínimos y baja escolaridad. De este total, el 88,9% presentó la forma clínica multibacilar de la enfermedad de Hansen y el 60% de ellos, con un nivel de deterioro de la calidad de vida que varía entre moderado y muy grave, según los puntajes del instrumento utilizado. Conclusión: Se confirma el importante impacto de la enfermedad de Hansen en la calidad de vida de sus portadores, como lo indican los altos puntajes obtenidos en la aplicación del DLQI

Objective: Evaluate the degree of impairment of the quality of life of people with Hansen's disease, according to social demographic and clinical variables Method: Descriptive, transversal, quantitative study, involving 45 patients from a reference hospital located in João Pessoa, Paraíba, Brazil. For obtaining data, interviews were performed based on a semi-structured questionnaire, including social demographic and clinic variables of the participants; to evaluate their life quality the instrument Dermatology Life Quality Index was used, after approval in the Committee of Ethics in Research of the Federal University of Paraíba. In the data analysis, the non-parametric Test of the Chi-square of Pearson was used with level of significance of 5% (p<0,05), being used the Yates correction continuity, when necessary. Results: It is highlighted a prevalence of male, brown, single, aged 18 to 40 individuals, with family income lower than three minimum salaries and low schooling. From this total, 88,9% presented the clinical multibacillary form of the Hansen's disease and 60% of them, with level of impairment of quality of life varying between moderate and very serious, according to scores of the instrument used. Conclusion: It is reassured the important impact of the Hansen's disease in the quality of life of their carriers, as indicated by the high scores obtained in the application of the DLQI

Objetivo: Avaliar o grau de comprometimento da qualidade de vida de pessoas com hanseníase, segundo variáveis sociodemográficas e clínicas. Método: Estudo descritivo, transversal, quantitativo, envolvendo 45 pacientes de um hospital de referência, localizado em João Pessoa, Paraíba, Brasil. Para obtenção dos dados, realizou-se entrevistas a partir de questionário semiestruturado, contemplando variáveis sociodemográficas e clínicas dos participantes; para avaliar sua qualidade de vida foi utilizado o instrumento Dermatology Life Quality Index, após aprovação do Comitê de Ética em Pesquisa da Universidade Federal da Paraíba. Na análise dos dados, utilizou-se o Teste não-paramétrico do Qui-quadrado de Pearson com nível de significância de 5% (p<0,05), sendo utilizado a Correção de Continuidade de Yates, quando necessário. Resultados: Evidencia-se uma prevalência dos indivíduos do sexo masculino, pardos, solteiros, com idade entre 18 e 40 anos, com renda familiar inferior a três salários mínimos e baixa escolaridade. Desse total, 88,9% apresentavam a forma clínica multibacilar da hanseníase e 60% deles, com grau de comprometimento da qualidade de vida vaiando de moderado a muito grave, segundo escores do instrumento utilizado. Conclusão: Reafirma-se o importante impacto da hanseníase na qualidade de vida de seus portadores, tal como indicado pelos altos escores obtidos na aplicação do DLQI

Humanos , Masculino , Feminino , Hanseníase/epidemiologia , Qualidade de Vida/psicologia , Questionário de Saúde do Paciente/estatística & dados numéricos , Psicometria/instrumentação , Cuidados de Enfermagem/métodos , Brasil/epidemiologia , Perfil de Impacto da Doença , Hanseníase Multibacilar/epidemiologia , Estudos Transversais , Hanseníase Paucibacilar/epidemiologia
Enferm. glob ; 18(56): 230-241, oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-188271


Objetivo: Determinar el nivel de depresión en pacientes diagnosticados con cáncer en una institución de IV nivel en Montería, Colombia. Metodología: Estudio descriptivo, transversal, con enfoque cuantitativo. Se aplicó el instrumento escala de Zung para depresión y una cédula de datos sociodemográficos en pacientes diagnosticados con cáncer, asistentes a una Institución especializada de IV nivel de complejidad de la ciudad de Montería. Resultados: Los tipos de cáncer más comunes fueron: el de mama 22,2%; y colon y útero igual representación 18,2%. En cuanto a la depresión se encontró ligeramente deprimido 49,5%; moderadamente deprimido 15,7%; severamente deprimido 1% y rango normal 33,8%. Los casos de depresión en sus diferentes categorías según la escala de Zung fueron encontrados en pacientes con cáncer de colon y mama. Conclusiones: Se encontró que en total 65,2% de los pacientes presentaban algún grado de depresión. La depresión en pacientes con cáncer es un fenómeno común en las personas con este padecimiento e incidencia es similar en hombres y mujeres, a su vez esta depende de factores tales como el tipo y severidad del cáncer, la edad y el acceso a redes de apoyo tanto para la persona como a la familia

Objective: To determine the level of depression in patients diagnosed with cancer in an IV level institution in Monteria, Colombia. Methodology: Descriptive, cross-sectional study, with a quantitative approach. The Zung scale instrument for depression and a sociodemographic data card were applied in patients diagnosed with cancer, attending a specialized institution of IV level of complexity in the city of Monteria. Results: The most common cancers were: breast cancer 22.2%; and colon and uterus equal representation 18.2%. Regarding depression, 49.5% were slightly depressed; moderately depressed 15.7%; severely depressed 1% and normal range 33.8%. Cases of depression in their different categories according to the Zung scale were found in patients with colon and breast cancer. Conclusions: It was found that in total 65.2% of the patients had some degree of depression. Depression in patients with cancer is a common phenomenon in people with this condition and incidence is similar in men and women, in turn this depends on factors such as the type and severity of cancer, age and access to support networks both for the person and the family

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Depressão/epidemiologia , Neoplasias/psicologia , Detecção Precoce de Câncer/psicologia , Questionário de Saúde do Paciente/estatística & dados numéricos , Colômbia/epidemiologia , Estudos Transversais , Fatores de Risco , Cuidados de Enfermagem/métodos , Carga Global da Doença/estatística & dados numéricos , Distribuição por Idade
JNMA J Nepal Med Assoc ; 57(217): 172-175, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31477957


INTRODUCTION: Co-morbid depression impacts negatively on quality of life in Chronic Kidney Disease patients. This study was done to calculate prevalence of depression in patients on hemodialysis (HD) using Patient Health Questionnaire-9, Hamilton Rating Scale for Depression-17 and International Classification of Disease-10 classification of mental and behavioural disorders. METHODS: It was descriptive cross-sectional study conducted from November 2017 till June 2018. Ethical approval was taken from Ethical Review Board, Nepal Health Research Council. Informed and written consent was taken. Patients undergoing hemodialysis at Nepal Medical College for more than 3 months duration were included in study. Patients on hemodialysis were asked to fill validated Nepali translated version of Patient Health Questionnaire-9. Psychiatrist administered Max Hamilton Rating scale for diagnosis and categorization of depression and confirmed depression based on International Classification of Disease-10. Statistical Package for Social Sciences version 20 was used for statistical analysis. RESULTS: The study was done among 100 patients. Prevalence of depression was 78 (78%) using Patient Health Questionnaire-9 and 65 (65%) using Max Hamilton Rating scale and 51 (51%) using International Classification of Disease -10. Mean depression in males using Patient Health Questionnaire -9 was 7±4.33 and in females was 11.04±5.90. Median age was 47.5 years. The most common symptom was fatigue among 82 (82%). CONCLUSIONS: There is a high prevalence of depression in patients with Chronic Kidney Disease stage 5 on hemodialysis compared to general population.

Depressão/epidemiologia , Falência Renal Crônica/psicologia , Qualidade de Vida , Diálise Renal , Adulto , Estudos Transversais , Feminino , Humanos , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Questionário de Saúde do Paciente , Prevalência , Escalas de Graduação Psiquiátrica , Centros de Atenção Terciária , Adulto Jovem
Postgrad Med ; 131(7): 533-538, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31478419


Introduction: Depression in patients with mild cognitive impairment (MCI) and dementia of the Alzheimer's type (AD) is associated with worse prognosis. Indeed, depressed MCI patients have worse cognitive performance and greater loss of gray-matter volume in several brain areas. To date, knowledge of the factors that can mitigate this detrimental effect is still limited. The aim of the present study was to understand in what way cognitive reserve/brain reserve and depression interact and are linked to regional atrophy in early stage AD. Methods: Depression was evaluated with the Patient Health Questionnaire-9 in 90 patients with early AD, and a cutoff of ≥ 5 was used to separate depressed (n = 44) from non-depressed (n = 46) patients. Each group was further stratified into high/low cognitive reserve/brain reserve. Cognitive reserve was calculated using years of education as proxy, while normalized parenchymal volumes were used to estimate brain reserve. Voxel-based morphometry was carried out to extract and analyze gray-matter maps. 2 × 2 ANCOVAs were run to test the effect of the reserve-by-depression interaction on gray matter. Age and hippocampal ratio were used as covariates. Composite indices of major cognitive domains were also analyzed with comparable models. Results: No reserve-by-depression interaction was found in the analytical models of gray matter. Depression was associated with less gray matter volume in the cerebellum and parahippocampal gyrus. The brain reserve-by-depression interaction was a significant predictor of executive functioning. Among those with high brain reserve, depressed patients had poorer executive skills. No significant results were found in association with cognitive reserve. Conclusion: These findings suggest that brain reserve may modulate the association between neurodegeneration and depression in patients with MCI and dementia of the AD type, influencing in particular executive functioning.

Doença de Alzheimer/psicologia , Disfunção Cognitiva/psicologia , Reserva Cognitiva , Depressão/psicologia , Substância Cinzenta/diagnóstico por imagem , Idoso , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/fisiopatologia , Atrofia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Cerebelo/diagnóstico por imagem , Cerebelo/patologia , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/fisiopatologia , Depressão/diagnóstico por imagem , Depressão/fisiopatologia , Feminino , Substância Cinzenta/patologia , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Giro Para-Hipocampal/diagnóstico por imagem , Giro Para-Hipocampal/patologia , Questionário de Saúde do Paciente
Ann Agric Environ Med ; 26(3): 420-424, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31559797


INTRODUCTION: Depressive disorders are one of the most common psychiatric disorders. Recognition of signs of mental health disorders is not always easy, hence the availability of simple and accurate tools for assessing them is very important in the practice of primary care. OBJECTIVE: The aim of the study is to assess the theoretical accuracy and reliability of the Patient Health Questionnaire-9 (PHQ-9) in Polish conditions, when applied to general population studies for adults aged between 35-64. MATERIAL AND METHODS: The study comprised a population of 4,040 people. Women constituted 59% of the research population and people living in the countryside 65%. The average age of participants was 53.45 ± 7.05 years. According to PHQ-9, 727 people (18.0%) had moderate, moderate to severe or severe depression. PHQ-9 showed a significant positive internal cohesion (Cronbach's alpha = 0.77), and factor charges oscillated between 0.43-0.63, and the R2 coefficients of determination were in the range of 0.21-0.40. CONCLUSIONS: The Polish version of PHQ-9 is a valid tool for diagnosing depression in the general population aged 35-64. Good psychometric properties and compactness make the PHQ-9 a useful clinical and research tool.

Depressão/psicologia , Questionário de Saúde do Paciente/estatística & dados numéricos , Psicometria/métodos , Adulto , Depressão/diagnóstico , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Polônia , Psicometria/instrumentação
BMC Public Health ; 19(1): 1270, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533670


BACKGROUND: The Getting it Right study determined the validity, sensitivity, specificity and acceptability of the culturally adapted 9-item Patient Health Questionnaire (aPHQ-9) as a screening tool for depression in Aboriginal and Torres Strait Islander (hereafter referred to as Indigenous) people. In this process evaluation we aimed to explore staff perceptions about whether Getting it Right was conducted per protocol, and if the aPHQ-9 was considered an acceptable and feasible screening tool for depression in primary healthcare. This process evaluation will provide information for clinicians and policy makers about the experiences of staff and patients with Getting it Right and what they thought about using the aPHQ-9. METHODS: Process evaluation using grounded theory approaches. Semi-structured interviews with primary healthcare staff from services participating in Getting it Right were triangulated with feedback (free-text and elicited) from participants collected during the validation study and field notes. Data were thematically analysed according to the Getting it Right study protocol to identify the acceptability and feasibility of the aPHQ-9. RESULTS: Primary healthcare staff (n = 36) and community members (n = 4) from nine of the ten participating Getting it Right services and Indigenous participants (n = 500) from the ten services that took part. Most staff reported that the research was conducted according to the study protocol. Staff from two services reported sometimes recruiting opportunistically (rather than recruiting consecutive patients attending the service as outlined in the main study protocol), when they spoke to patients who they knew from previous interactions, because they perceived their previous relationship may increase the likelihood of patients participating. All Getting it Right participants responded to at least six of the seven feedback questions and 20% provided free-text feedback. Most staff said they would use the aPHQ-9 and most participants said that the questions were easy to understand (87%), the response categories made sense (89%) and that they felt comfortable answering the questions (91%). CONCLUSION: Getting it Right was predominantly conducted according to the study protocol. The aPHQ-9, the first culturally adapted, nationally validated, freely available depression screening tool for use by Indigenous people, appears to be acceptable and feasible to use. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry ANZCTR12614000705684 , 03/07/2014.

Depressão/diagnóstico , Programas de Rastreamento/normas , Grupo com Ancestrais Oceânicos/psicologia , Adulto , Austrália , Estudos de Viabilidade , Feminino , Serviços de Saúde do Indígena/normas , Humanos , Masculino , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Questionário de Saúde do Paciente , Atenção Primária à Saúde , Projetos de Pesquisa
Reprod Health ; 16(1): 137, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31500644


BACKGROUND: Depression in patients with infertility often goes undiagnosed and untreated. The Patient Health Questionnaire-9 (PHQ-9) and its ultra-brief version (i.e. PHQ-2) are widely used measures of depressive symptoms. These scales have not been validated in patients with infertility. The aim of the present study was to examine the reliability and validity of the PHQ-9 and PHQ-2 in patients with infertility. METHODS: In this cross-sectional study, a total of 539 patients with infertility from a referral infertility clinic in Tehran, Iran completed the PHQ-9, along with other relevant scales: the WHO-five Well-being Index (WHO-5), the Hospital Anxiety and Depression Scale (HADS), and the Generalized Anxiety Disorder-7 (GAD-7). Factor structure and internal consistency of PHQ-9 were examined via confirmatory factor analysis (CFA) and Cronbach's alpha, respectively. Convergent validity was evaluated by relationship with WHO-5, HADS and GAD-7. RESULTS: The mean total PHQ-9 and PHQ-2 scores were 8.47 ± 6.17 and 2.42 ± 1.86, respectively, and using a cut-off value of 10 (for PHQ-9) and 3 (for PHQ-2), the prevalence of depressive symptoms was 38.6 and 43.6%, respectively. The Cronbach's alphas for PHQ-9 and PHQ-2 were, respectively, 0.851 and 0.767, indicating good internal consistency. The CFA results confirmed the one-factor model of the PHQ-9 (χ2/df = 4.29; CFI = 0.98; RMSEA = 0.078 and SRMR = 0.044). Both PHQ-9 and PHQ-2 showed moderate to strong correlation with the measures of WHO-5, HADS-depression, HADS-anxiety, and the GAD-7, confirming convergent validity. In univariate analysis, female sex, long infertility duration, and unsuccessful treatment were significantly associated with depression symptoms. CONCLUSION: Both PHQ-9 and PHQ-2 are brief and easy to use measures of depressive symptoms with good psychometric properties that appear suitable for routine use in patients with infertility.

Transtornos de Ansiedade/diagnóstico , Transtorno Depressivo/diagnóstico , Infertilidade/psicologia , Programas de Rastreamento/estatística & dados numéricos , Questionário de Saúde do Paciente/normas , Escalas de Graduação Psiquiátrica/normas , Adulto , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Estudos Transversais , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Infertilidade/fisiopatologia , Irã (Geográfico)/epidemiologia , Masculino , Reprodutibilidade dos Testes
Rev. esp. anestesiol. reanim ; 66(7): 362-369, ago.-sept. 2019. graf
Artigo em Espanhol | IBECS | ID: ibc-187549


Antecedentes y objetivo: En los pacientes con gonalgia por gonartrosis, disponemos de tratamientos no exentos de efectos secundarios. Objetivo: evaluar la eficacia analgésica de la radiofrecuencia (pulsada y convencional) sobre el nervio safeno a nivel subsartorial y los nervios geniculares de la rodilla, mediante la localización por ultrasonografía. Materiales y métodos: Ensayo clínico prospectivo, aleatorizado, doble ciego. G1 (RDF1): sujetos sometidos a radiofrecuencia, G2 (PLCB): sujetos sometidos a placebo. Se consideró clínicamente relevante una disminución ≥30% del dolor, según escala visual numérica y en el Western Ontario and McMaster Universities Osteoartritis Index, cuestionario de impresión global del paciente (PGIC) y cuestionario de estado de salud (SF-12) en la evaluación al mes, a los tres meses y a los seis meses de la realización de la técnica. Resultados: Veintiocho pacientes (G1: 12, G2: 16), 72% mujeres, edad: 75,2 (9,1) años, índice de masa corporal: 29,9 (4,64). El análisis no mostró una reducción del dolor, ni estadísticamente significativa, ni clínicamente relevante, al mes, tres, o seis meses respecto al inicio del tratamiento, en el cuestionario Western Ontario and McMaster Universities Osteoartritis Index y en la escala visual numérica (reposo, movimiento). Respecto al PGIC y al cuestionario SF-12, tampoco existieron diferencias estadísticamente significativas entre G1 y G2 antes ni después del tratamiento. Conclusiones: La combinación de dos técnicas de radiofrecuencia, no provoca una reducción en la intensidad de la gonalgia, al mes, tres, ni a los seis meses después de su realización. Es necesario cambiar la técnica de radiofrecuencia e incluir más variables para proseguir con el estudio de eficacia

Background and objective: In patients with knee pain due to gonarthrosis, we have treatments that are not free of side effects. Objective: to evaluate the analgesic efficacy of radiofrequency (pulsed and conventional) on the saphenous nerve at the subsartorial level and the genicular nerves of the knee, by ultrasonography. Materials and methods: Prospective, randomized, double-blind clinical trial. G1 (RDF1): subjects subjected to radiofrequency, G2 (PLCB): subjects subjected to placebo. A decrease ≥30% of the pain was considered clinically relevant, according to numerical rating scale and in the Western Ontario and McMaster Universities Osteoarthritis Index, global patient impression questionnaire (PGIC) and health status questionnaire (SF-12) in the evaluation at month, three months and six months after the completion of the technique. Results: 28 patients (G1: 12, G2: 16), 72% women, age: 75.2+/-9.1 years, body mass index: 29.9+/-4.64. The analysis did not show a pain reduction, neither statistically significant, not clinically relevant, at one month, three, or six months with respect to the start of treatment, in the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire and numerical rating scale (rest, movement). Regarding PGIC and the SF-12 questionnaire, there were no statistically significant differences between G1 and G2 either before or after treatment. Conclusions: The combination of two radiofrequency techniques, does not cause a reduction in the intensity of the knee pain, at month, three, or at six months after its completion. It is necessary to change the radiofrequency technique and include more variables to continue with the efficacy study

Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Osteoartrite do Joelho/complicações , Terapia por Radiofrequência/métodos , Artralgia/terapia , Estudos Prospectivos , Método Duplo-Cego , Segurança do Paciente , Resultado do Tratamento , Analgesia/métodos , Manejo da Dor/métodos , Joelho/inervação , Questionário de Saúde do Paciente/estatística & dados numéricos
Enferm. nefrol ; 22(3): 239-255, jul.-sept. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-187881


Objetivo: Identificar las variables más influyentes en la calidad de vida relacionada con la salud en pacientes en diálisis, identificando los instrumentos de medida más utilizados. Material y Método: Se ha realizado una revisión sistemática en las bases de datos PubMed, Scopus, Google Académico y Scielo. Se han incluido artículos científicos en inglés y español. Se han analizado artículos que tratan la calidad de vida relacionada con la salud en pacientes en diálisis, excluyendo aquellos artículos que no aportaban resultados concluyentes, en población pediátrica y en los que se analizaba este parámetro exclusivamente en pacientes trasplantados. Resultados: Se han incluido 36 artículos publicados entre 2009-2019. La calidad de vida relacionada con la salud aparece disminuida en todos los pacientes en diálisis, más concretamente en hemodiálisis. Las variables más influyentes en la disminución de la calidad de vida relacionada con la salud del paciente en diálisis, son: sexo femenino, edad avanzada, no poseer un núcleo familiar, estudios primarios, y afectación de la situación laboral en pacientes en edad para trabajar; además de comorbilidad asociada a la patología renal, ansiedad y depresión, presencia de dolor y con grado de dependencia alto. Conclusiones: La disminución de la calidad de vida está presente en la mayoría de los pacientes de diálisis, con más frecuencia en hemodiálisis. Respecto a los instrumentos de evaluación empleados, el más utilizado es el KDQOL-SF. Esta pérdida de la calidad de vida se relaciona con ser mujer, edad avanzada, comorbilidad asociada, dolor con limitaciones, presencia de ansiedad y/o depresión y mayor dependencia

Objective: To identify the most influential variables in health-related quality of life in dialysis patients, identifying the most common measuring instruments. Material and Method: A systematic review was carried out in the PubMed, Scopus, Google Scholar and Scielo databases. Scientific articles in English and Spanish have been included. Articles that evaluate health-related quality of life in dialysis patients, excluding those articles that did not provide conclusive results, in the pediatric population and those that addressed this parameter exclusively in transplanted patients, were analyzed. Results: 36 articles published between 2009-2019 have been included. Health-related quality of life appears diminished in all dialysis patients, more specifically in hemodialysis. The most influential variables in the decrease of the health-related quality of life of the dialysis patient are: female sex, older age, not having a family nucleus, primary studies, and affectation of the employment situation in patients of working age; in addition to comorbidity associated with kidney disease, anxiety and depression, presence of pain and high degree of dependence. Conclusions: The decrease in the quality of life is present in many dialysis patients, more frequently in hemodialysis. Regarding the evaluation instruments used, the most used is the KDQOL-SF. This loss of quality of life is related to being a woman, old age, associated comorbidity, pain with limitations, presence of anxiety and/or depression and greater dependence

Humanos , Qualidade de Vida/psicologia , Insuficiência Renal Crônica/terapia , Diálise Renal/psicologia , Psicometria/instrumentação , Questionário de Saúde do Paciente/estatística & dados numéricos , Insuficiência Renal Crônica/psicologia , Diálise Renal/estatística & dados numéricos , Fatores de Risco
Enferm. nefrol ; 22(3): 274-283, jul.-sept. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-187884


Objetivo: El objetivo del presente estudio fue analizar la Calidad de Vida Relacionada con la Salud en pacientes hemodiálisis y su relación con la ansiedad y la depresión. Pacientes y Método: Se estudiaron 122 pacientes en hemodiálisis, con una edad de 66,47+/-14,2 años (34,4% mujeres). Se realizó un estudio descriptivo y transversal, en el área de influencia del Servicio de Nefrología del Hospital Reina Sofía de Córdoba. Se estudió la Calidad de Vida Relacionada con la Salud (cuestionario KDQOL-SF), Ansiedad y Depresión (cuestionario Escala de Ansiedad y Depresión de Goldberg) y la comorbilidad asociada. Resultados: En el KDQOL, las dimensiones más afectadas fueron: Situación Laboral, Carga de la Enfermedad Renal, Función Sexual y Sueño. En las dimensiones del cuestionario SF, las áreas más afectadas fueron: Rol Físico, Salud General y Función Física. El 42,6% de los pacientes presentaron probabilidad de tener ansiedad, el 52,5% depresión, y el 32,8% presentaban la probabilidad de padecer ambas alteraciones (ansiedad y depresión). La ansiedad y la depresión se asociaron de forma significativa a peores puntuaciones en todas las dimensiones del cuestionario KDQOL-SF. Conclusiones: Los pacientes en hemodiálisis presentan peor calidad de vida que la población sana de referencia, especialmente en las dimensiones Carga de la enfermedad renal, Sueño, Salud general, Vitalidad, Función física y Rol físico. Esta disminución de la calidad de vida está relacionada con la probabilidad de padecer ansiedad y/o depresión. El sexo femenino, la comorbilidad asociada y el tiempo en hemodiálisis, se asocian también a peor calidad de vida

Objective: The aim of the present study was to analyze the health-related quality of life in hemodialysis patients and their relationship with anxiety and depression. Material and Method: One hundred and twenty-two hemodialysis patients were studied, with an age of 66.47 +/- 14.2 years (34.4% women). A descriptive and cross-sectional study was carried out in around the Nephrology Unit of the Reina Sofía University Hospital of Cordoba. The health-related quality of life (KDQOL-SF questionnaire), anxiety and depression (Goldberg Anxiety and Depression Scale questionnaire) and associated comorbidity were studied. Results: In the KDQOL scale, the most affected dimensions were: Work Status, Kidney Disease Burden, Sexual Function and Sleep. In the dimensions of the SF questionnaire, the most affected areas were: Physical Role, General Health and Physical Function. 42.6% of the patients presented probability of having anxiety, 52.5% depression, and 32.8% had the probability of suffering both alterations (anxiety and depression). Anxiety and depression were significantly associated with worse scores in all dimensions of the KDQOL-SF questionnaire. Conclusions: Hemodialysis patients have a worse quality of life than the healthy reference population, especially in the Kidney Disease Burden, Sleep, General health, Vitality, Physical Function and Physical Role dimensions. This decrease in the quality of life is related to the probability of suffering anxiety and/or depression. Female sex, associated comorbidity and length of time on hemodialysis are also associated with a worse quality of life

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Diálise Renal/psicologia , Insuficiência Renal Crônica/psicologia , Qualidade de Vida/psicologia , Ansiedade/psicologia , Depressão/psicologia , Dor/psicologia , Diálise Renal/enfermagem , Insuficiência Renal Crônica/terapia , Perfil de Impacto da Doença , Questionário de Saúde do Paciente/estatística & dados numéricos
Actas esp. psiquiatr ; 47(4): 137-148, jul.-ago. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-185164


Objetivos. La "Escala de Discriminación y Estigma" (DISC) fue el primer instrumento diseñado para evaluar experiencias de discriminación referidas por pacientes con trastornos mentales. El objetivo principal de este estudio es validar la versión española de la escala DISC 12 en población con esquizofrenia y, como objetivos específicos, realizar la validación externa con el Cuestionario de Autoestigma (SSQ) y la Escala de Link (PDD) y validar su consistencia interna y la fiabilidad temporal y entre observadores. Métodos. 86 individuos con esquizofrenia fueron entrevistados en dos tiempos (entre una y dos semanas) por dos evaluadores. Se estudiaron sus características sociodemo-gráficas y clínicas y se aplicaron las escalas: DISC-12, SSQ, PDD, Escala de Funcionamiento Social (SFS) y Evaluación del Funcionamiento (GAF). Resultados. La consistencia interna resultó un a Cronbach entre 0,741 y 0,850. Las subescalas "Trato injusto" y "Trato positivo" tuvieron a Cronbach superior a 0,79, pero las subscalas "Anticipación de la discriminación" y "Superación del estigma" no tuvieron adecuada consistencia. La fiabilidad test-retest de las cuatro subescalas fue superior a 0,67. La fiabilidad entre evaluadores mostró que 21 ítems tuvieron puntuación superior a 0,8, 10 entre 0,6-0,8 y uno, menos de 0,6. DISC-12 se relacionó significativamente con el Segundo factor de PDD (self-stigma) y con SSQ. Conclusiones. La versión española de la escala DISC 12 es válida, tiene una buena consistencia interna, buena fiabilidad test-retest y entre evaluadores y tiene una buena validez convergente con la SSQ y PDD. Las subescalas "Trato injusto" y "Trato positivo" son las más robustas"

Aims. The "Discrimination and Stigma Scale" (DISC) was the first instrument specifically designed to evaluate reported experiences of discrimination by people with mental dis-orders. This study aims to validate DISC-12 version in Spanish population with Schizophrenia and, as specific objectives, to do the external validation with the Self-Stigma Questionnaire (SSQ) scale and Link PDD scale and to validate their internal consistency, temporal and inter-rater reliability. Methods. 86 individuals with schizophrenia were interviewed at two time points (between one to two weeks) by two raters. Additionally to assess their sociodemographic and clinical characteristics, following scales were administered: DISC 12, SSQ, PDD, Social Functioning Scale (SFS) and Global Assessment of Function (GAF).Results. Internal consistency as a whole results a Cronbach a between 0.741 and 0.850. Subscales "Unfair treatment" and "Positive treatment" have a Cronbach a higher than 0.79, but the both subscales "Stopping Self" and "Over-coming stigma" do not have in themselves an adequate consistency. Test-retest reliability shows that four subscales have values higher than 0.67. Inter-rater reliability assessment result that 21 items score values above 0.8, 10 be-tween 0.6-0.8 and one lower than 0.6. DISC-12 was significantly related with the second factor of the PDD (self-stigma) and SSQ. Conclusions. The Spanish version of the DISC 12 scale is valid, has good internal consistency, is reliable both in terms of test-retest and inter-rater reliability and has good convergent validity with the SSQ and PDD, and the "Unfair treatment" and "Positive Treatment" subscales were the most robust of the four subscales

Humanos , Discriminação Psicológica , Transtornos Mentais/psicologia , Esquizofrenia , Psicologia do Esquizofrênico , Psicometria , Escalas de Graduação Psiquiátrica , Questionário de Saúde do Paciente , Inquéritos e Questionários
Psicothema (Oviedo) ; 31(3): 335-340, ago. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-185362


Background: The Brief Experiential Avoidance Questionnaire (BEAQ) has been suggested as the most appropriate instrument for measuring experiential avoidance. However, no Spanish validation has been published. The aim of this study was to validate a Spanish version of the BEAQ in a clinical sample treated at a community mental health unit. Methods: Participants (N = 332) completed the BEAQ as well as other self-report measures of experiential avoidance and psychopathology. Results: Internal consistency was satisfactory (α = .82). No statistically significant gender differences were found in the BEAQ scores. The data also showed high test-retest reliability after four to six weeks, acceptable concurrent validity with another experiential avoidance measure and acceptable convergent validity with the psychopathology measure. The principal component analysis, forcing the one factor solution proposed in the original scale, produced indicators similar to the English version of the BEAQ. Conclusions: These results firmly support the reliability and validity of this Spanish validation, stressing its usefulness as a measure of experiential avoidance in clinical populations

Antecedentes: el Cuestionario Breve de Evitación Experiencial (BEAQ) ha sido propuesto como el instrumento más adecuado para medir la evitación experiencial. Sin embargo, todavía no ha sido publicada ninguna validación en español. Por lo tanto, el objetivo del presente estudio ha sido la validación de una versión española del BEAQ, en una muestra clínica atendida en un Centro de Salud Mental Comunitario. Método: los participantes (N = 332) completaron el BEAQ, así como otras medidas de autoinforme de evitación experiencial y psicopatología. Resultados: la consistencia interna fue satisfactoria (α = .82). No se encontraron diferencias de género estadísticamente significativas en las puntuaciones del BEAQ. Los datos también mostraron una alta fiabilidad test-retest en un intervalo de cuatro a seis semanas, validez concurrente aceptable con otra medida de evitación experiencial y validez convergente aceptable con la medida de psicopatología. El análisis de componentes principales forzando a la solución de un factor, como se propuso en la escala original, obtuvo unos indicadores similares a los obtenidos en dicha versión inglesa. Conclusiones: los resultados confirman la adecuada fiabilidad y validez de la presente versión española del BEAQ, destacando su utilidad como medida de la evitación experiencial en población clínica

Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Questionário de Saúde do Paciente , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Autorrelato , Transtornos de Adaptação/diagnóstico , Transtornos de Adaptação/psicologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Transtorno Distímico/diagnóstico , Transtorno Distímico/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , Psicometria , Reprodutibilidade dos Testes , Fatores Sexuais , Espanha
Arch. argent. pediatr ; 117(4): 252-258, ago. 2019. tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1054929


Introducción. La Escala hospitalaria de Ansiedad y Depresión (Hospital Anxiety and Depression Scale, HADS) es un instrumento de pesquisa, utilizado para evaluar sintomatología emocional en diferentes poblacionesy patologías médicas. Este estudio analiza las propiedades psicométricas y la estructura factorial de la HADS en adolescentes con enfermedad crónica y las diferencias en función de la patología médica. Método. La HADS fue administrada a una muestra de 302 adolescentes con enfermedad crónica. Se realizaron análisis factoriales exploratorios con una submuestra de 100 adolescentes y análisis factoriales confirmatorios con el resto de los participantes (202) para analizar la validez y fiabilidad de la HADS (14 ítems); además se calculó el análisis de la varianza de un factor para analizar las diferencias entre patologías. Resultados. Pacientes de 12 a 16 años de edad, con una distribución similar por género; el 43 % padecía enfermedades respiratorias, y el 47 %, endocrinológicas. La estructura original de dos factores (ansiedad y depresión) fue la que mostró buenos índices de ajuste e incorporó un factor de 2° orden (malestar emocional). Tres de los ítems originales de la escala fueron eliminados; se obtuvo, finalmente, una nueva versión de 11 ítems. Esta mostró adecuadas propiedades psicométricas y se observaron diferencias entre pacientes con diabetes mellitus 1 y con patología respiratoria, pero no en talla baja, en el factor de depresión. Conclusiones. Esta escala presenta una adecuada fiabilidad y validez en pacientes con enfermedad crónica pediátrica y resulta útil para la detección temprana de clínica ansioso-depresiva en el ámbito sanitario.

Introduction. The Hospital Anxiety and Depression Scale (HADS) is a screening instrument that assesses emotional symptoms in different populations and medical conditions.This study analyzes the psychometric properties and factor structure of the HADS in adolescents with chronic disease and the differences based on their medical condition. Method. The HADS was administered to a sample of 302 adolescents with chronic disease. Exploratory factor analyses were done in a sub-sample of 100 adolescents, while confirmatory factor analyses were performed in the rest of participants (202) to examine the validity and reliability of the HADS (14 items); an analysis of variance for a single factor was also done to study differences among diseases.Results. Patients were aged 12-16 years, with a similar sex ratio; 43 % had respiratory diseases and 47 %, endocrine disorders. The original two-factor structure (anxiety and depression) showed adequate fit indices and incorporated a second-order factor (emotional distress). Three of the original items were removed, thus obtaining a new 11-item version. This showed adequate psychometric properties, and differences were observed between patients with type 1 diabetes mellitus and those with respiratory disease, but not in terms of short stature, in the depression factor.Conclusions. The HADS displays an adequate reliability and validity in pediatric patients with chronic disease and is useful for the early detection of anxiety and depression in the health care setting

Humanos , Masculino , Feminino , Adolescente , Ansiedade , Doença Crônica/psicologia , Depressão , Questionário de Saúde do Paciente , Espanha , Estudos Transversais , Reprodutibilidade dos Testes , Análise Fatorial