RESUMEN
This study examined the relationship between clinical and psychosocial variables and unipolar major depression outcome. Ninety ambulatory patients, with an index phase duration of less than 6 months, were followed-up for 12 months. Two measures of outcome were used: persistence of severe or partial symptomatology. Sixty percent of the patients were asymptomatic (HDRS < 8), 24% improved but not totally and 17% persisted with severe symptomatology (HDRS> 18). Personality disorder, recurrent depression, low self-esteem and low satisfaction with social support were associated to non-full remission. Personality disorder and low satisfaction with social support were associated to non-improvement. This work underlines the need during treatment to take into account personality and social variables.
Asunto(s)
Trastorno Depresivo Mayor/diagnóstico , Adulto , Trastorno Depresivo Mayor/psicología , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Satisfacción del Paciente , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/psicología , Pronóstico , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Autoimagen , Índice de Severidad de la Enfermedad , Apoyo SocialRESUMEN
A number of authors have indicated in recent years that the course of depression is not as favourable as previously expected. Research conducted in order to identify predictors of recovery has shown widely different results. In this paper a sample of 90 consecutive patients with non-chronic major depressive disorders (index episode < 6 months) attending four mental health centres in Madrid were followed up prospectively for 6 months, and clinical social and cognitive variables were studied. The patients were treated pharmacologically and controlled. The rate of recovery was measured according to the Hamilton Rating Scale for Depression (HAM-D). Other tools used were: Life Events and Chronic Difficulties, Global Assessment Functioning in the 6 months prior to the onset of episode, Brown Rating Scale for Self-Esteem and Mannheim Interview of Social Support. The results showed that 41 cases recovered (HAM-D score < 8), 29 cases achieved a partial remission, and major depressive disorder persisted in 17 cases (HAM-D score > or = 18). The presence of personality disorders, having suffered a previous episode, GAF score and some aspects of social support were the variables most associated with non full remission in the logistic regression analysis. Personality disorders and the initial HAM-D score were related to non-improvement. Some clinical and cognitive variables maintain a weak relation to outcome and are rejected in logistic regression. This study emphasizes the relationship of personality, and social variables such as social support and previous global functioning, with incomplete recovery in major depression.
Asunto(s)
Trastorno Depresivo/terapia , Adolescente , Adulto , Anciano , Distribución de Chi-Cuadrado , Trastorno Depresivo/complicaciones , Femenino , Estudios de Seguimiento , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Trastornos de la Personalidad/complicaciones , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Prevención Secundaria , Apoyo Social , Resultado del TratamientoRESUMEN
OBJECTIVE: To find the value of the bone mass measured by ultrasonics in pre- and postmenopausal women. DESIGN: A descriptive study of a crossover type. SETTING: Primary Care, Tórtola Health Centre, Valladolid. PATIENTS: Women over 35 assigned to Tórtola HC selected at random with age stratification. Sample of 266 women. MEASUREMENTS AND MAIN RESULTS: Determination of the bone mass through BUA ultrasonics technique: UBA 575 Walker Sonix. BUA Value in the sample: 70.77 +/- 15.57 dB/MHz. Proportion of values below that expected from the reference values: 9.02% +/- 0.02. Statistically significant differences were found among the different age groups, with BUA values lower in older patients. The accumulated percentage of fall in the BUA value in the 35 to 86 age range was 24.26%. The BUA value in pre-menopausal women was 76.61 +/- 13.23 dB/MHz and 65.10 +/- 15.57 dB/MHz in post-menopausal women, with a statistically significant difference (p < 0.01), which remained significant even when the variables (age, no childbirth, size and ICM) were considered. The percentage of fall of the BUA value in the first ten years after the menopause was 15.04%. CONCLUSIONS: The structural bone values measured in our sample, using an easily-managed portable ultrasonic bone analyser, presented falls linked to age and to the menopause, independently of any other variables studied.