RESUMO
Meta-analytical evidence suggests that brain-derived neurotrophic factor (BDNF) is altered in various psychiatric disorders. However, meta-analyses may be hampered by the heterogeneity of BDNF assays, lack of BDNF standard values and heterogeneity among the populations included in the studies. To address these issues, our study aimed to test, in a 'true-to-life' setting, the hypothesis that the serum BDNF level is nonspecifically reduced in acute severe mental illness (SMI) patients and increases during inpatient treatment. Consecutive samples of 236 inpatients with SMI and 100 healthy controls were recruited. SMI includes schizophrenia and severe mood disorders, and is characterized in the sample by the presence of at least 2 years of psychiatric treatment and disability. Generalized estimating equations were used to analyze BDNF serum levels at admission and upon discharge controlled by confounding factors. BDNF levels increased significantly between admission and discharge in SMI patients. BDNF levels showed significant reductions compared with controls both at admission and upon discharge. In addition, BDNF levels showed no difference among SMI patient diagnostic subgroups (unipolar depression, bipolar depression, schizophrenia and manic episode). The increase but non-restoration of BDNF levels, even with the general acute improvement of clinical scores, may reflect the progression of the disorder characteristically seen in these patients. BDNF levels could be considered as a marker for the presence of a nonspecific psychiatric disorder and possibly a transdiagnostic and nonspecific marker of disease activity.
Assuntos
Fator Neurotrófico Derivado do Encéfalo/sangue , Hospitalização , Transtornos Mentais/sangue , Transtornos Mentais/terapia , Adulto , Transtorno Bipolar/sangue , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtorno Bipolar/terapia , Brasil , Transtorno Depressivo Maior/sangue , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/terapia , Feminino , Seguimentos , Hospitais Gerais , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Unidade Hospitalar de Psiquiatria , Esquizofrenia/sangue , Esquizofrenia/diagnóstico , Esquizofrenia/terapia , Psicologia do EsquizofrênicoRESUMO
BACKGROUND: Physical exercise has been extensively researched as a therapeutic option for treatment of major depression. METHODS: In a randomized controlled trial, we analyze the effects of aerobic physical exercise as an add-on strategy for treatment of severe depressed inpatients. The exercise has a "Dose" of 16.5 kcal/kg/week, three times a week during all the hospitalization. RESULTS: Our preliminary results show that there is no significant difference in scores of Hamilton in the second week between groups (Mean[SD]=8.2[5.96] × 11.18[5.03], p=0.192). However, there is a significant reduction in Hamilton scores of patients in exercise group at discharge (Mean[SD]=5.93[4.46] × 9.45[3.56], p=0.041). Regarding Quality of Life (QoL), no significant difference were found between groups in the second week in physical domain (Mean[SD]=56.98[8.96] × 54.54[9.18], p=0.511) and psychological domain (Mean[SD]=50.88[13.88] × 42.04[12.42], p=0.106). However, there is a significant difference in psychological domain (Mean[SD]=55.88[9.92] v 41.66[13.04], p=0.004) and a trend but no statistical significance in the physical (Mean[SD]=58.80[9.14] × 52.12[8.70], p=0.07) at discharge. LIMITATIONS: Many patients receive different treatment strategies, like ECT (1 patient at exercise group × 3 at control group). Other limitation is the small number of participants included until this moment. CONCLUSION: Our preliminary results suggest that physical exercise could be a feasible and effective add-on strategy for treatment of severe depressed inpatients, improving their depressive symptoms and QoL.
Assuntos
Transtorno Depressivo/terapia , Terapia por Exercício , Qualidade de Vida , Adulto , Depressão/terapia , Transtorno Depressivo/psicologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/terapia , Ingestão de Energia , Exercício Físico/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
BACKGROUND: It has been consistently demonstrated that infertility is associated with quality of life (QOL) impairments. Research to date has mostly focused on individual's reactions to infertility (mainly women), without an examination of how the partner is reacting to the same condition. The few studies that assessed QOL among couples did not use couple-based analyses, consequently not considering the intra-couple effects. The objectives of this study were to explore the congruence of QOL perception within infertile couples and to estimate the effect of depression levels on the congruence. METHODS: In total, 162 couples were interviewed in an assisted reproduction clinic cross-sectionally. Subjects completed a socio-demographic form, World Health Organization Quality of Life-BREF and the Beck Depression Inventory independently. The statistical strategy was guided to ensure that subjects would be explored within pairs at all times and not as independent groups. Paired t-tests were run, and Cohen's effect was estimated. Depression levels were controlled by linear multiple regressions and repeated-measures ANCOVAs. RESULTS: Out of the five QOL domain scores, only two showed a significant discrepancy between partners (psychological and social relationship domains). Male depression was a significant predictor for all five QOL difference scores, whereas female depression was associated with three (overall, psychological and physical). Moreover, it was demonstrated that, except for the psychological domain and for the female depression on the physical domain, the load of depression as a predictor of the QOL difference scores was markedly low, accounting for not more than 7.5% of the variance of congruence between men's and women's QOL. CONCLUSION: Our findings suggest that QOL scores do not differ markedly between spouses. Since QOL seemed similarly affected in both men and women, consideration might be given to offering interventions to them as a dyad. These results are not in line with the previous non-paired studies, and further investigations are required to address this dissimilarity.
Assuntos
Características da Família , Infertilidade/psicologia , Qualidade de Vida/psicologia , Adulto , Estudos Transversais , Transtorno Depressivo/etiologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Infertilidade/complicações , Infertilidade Feminina/complicações , Infertilidade Feminina/psicologia , Infertilidade Masculina/complicações , Infertilidade Masculina/psicologia , Masculino , Estudos ProspectivosRESUMO
The importance of Quality of Life (QOL) evaluation is a recognized outcome in HIV-related studies. The objective of this study was to test the psychometric properties of the Brazilian version of the WHOQOL-HIV. The QOL of 308 HIV-infected men and women was assessed in the different HIV disease severity stages. Women, younger (<35 years) and married patients were associated with a lower QOL. Psychometric properties of the Brazilian version of WHOQOL-HIV were evaluated: reliability, construct validity, discriminant and concurrent validity. Cronbach alpha was above 0.70 in 27 of the 31 facets of the WHOQOL-HIV and ranged between 0.32 and 0.65 in the remaining four facets. Better QOL scores occurred in early stages of the infection (asymptomatic and symptomatic groups) while the AIDS group showed worse scores in all domains of WHOQOL-HIV, with statistically significant differences in early stages. The correlation between the domains and overall QOL was statistically significant (r>0.5; p<0.01). The Brazilian version of the WHOQOL-HIV adequately discriminated between the QOL of individuals in the different stages of HIV infection, in the expected direction and demonstrated satisfactory reliability and concurrent validity in this study. It would appear to be a useful tool to assess the subjective QOL in people living with HIV and AIDS.
Assuntos
Infecções por HIV/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Adulto , Análise de Variância , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Organização Mundial da SaúdeRESUMO
INTRODUCTION: The need of short instruments to evaluate Quality of life determines World Health Organization Quality of Life Group (WHOQOL Group) to develop an abbreviated version of the WHOQOL-100, the WHOQOL-bref. The objective is to present the Brazilian field trial of the WHOQOL-bref. METHODS: WHOQOL-bref is composed by 26 questions divided in four domains: physical, psychological, social relationships and environment. The evaliation instrument, BDI (beck depression inventory) and BHS (beck hopelessness scale) were used in a 300 subjects sample in Porto Alegre, South Brazil. RESULTS/CONCLUSIONS: The instrument showed a good performance concerning internal consistency, discriminant validity, criterion validity, concurrent validity and test-retest reliability. The intrument allies good psychometric performance and practicity for use which puts it as an interesting option to evaluate quality of life in Brazil.
Assuntos
Qualidade de Vida , Organização Mundial da Saúde , Brasil , Estudos de Casos e Controles , Estudos de Avaliação como Assunto , Feminino , Humanos , Modelos Lineares , Masculino , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: The WHOQOL group have developed an instrument to evaluate Quality of Life, the WHOQOL-100, available in 20 different languages (WHOQOL Group, 1998). The field trial of the portuguese version of the instrument is presented. METHODS: Two hundred and fifty patients from four main medical areas (Psychiatry, Clinical, Surgery and Ginecology) of the Hospital de Clínicas de Porto Alegre and 50 controls were evaluated with the Portuguese version of the WHO Quality of Life Instrument (WHOQOL-100), Beck Depression Inventory (BDI) and Beck Hopelessness Scale (BHS) in Porto Alegre, south Brazil. RESULTS AND CONCLUSION: The instrument showed a good psychometric performance with good internal consistency, discriminant validity, criterion validity, concurrent validity and reliability. The authors conclude that the intrument is ready for use in Brazil, it being important to evaluate its performance in other regions and with different samples.
Assuntos
Estudos de Avaliação como Assunto , Qualidade de Vida , Organização Mundial da Saúde , Adulto , Feminino , Humanos , MasculinoRESUMO
OBJECTIVE: There are many methods to determine how many components should be retained in principal components analysis. This choice can be made on the basis of arbitrary (Kaiser) or subjective (Interpretable factors) criteria. This work presents the simulation criteria of Lébart e Dreyfus. The method create a matrix of randomized numbers and a principal component analysis is performed on the basis of this matrix. The components extracted from this data represent the cut off values. Those that exceed this cut off value should be retained. As an example, a principal component analysis is performed with the Hamilton depression rating scale (17 items) on a sample of 130 subjects. RESULTS AND CONCLUSION: The Simulation method is compared with the Kaiser method and is shown that the Simulation method maintains the components clinically significant.
Assuntos
Depressão/diagnóstico , Modelos Lineares , Modelos Estatísticos , Escalas de Graduação Psiquiátrica , Depressão/fisiopatologia , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Análise Multivariada , Autoavaliação (Psicologia)RESUMO
The Hamilton Depression Rating Scale was applied to 60 depressed inpatients diagnosed using the Composite International Diagnostic Interview. The information to rate the scale was obtained with a semistructured interview to standardize the scale administration method. Items were factorized using principal components analysis with Varimax rotation. Three factors were obtained with the simulation method, accounting for 47% of variance. The first includes the core symptoms of depression. The symptoms of patients having an isolated mood disorder were compared with those having comorbidity with other diagnoses. The comorbidity did not affect the first factor but modified the second factor (anxiety) and the third factor (insomnia).