RESUMO
BACKGROUND: Depression is a common problem among those suffering from diabetes mellitus. The dual diagnoses of a chronic medical disease and mental disorder, symptomatic presentation and stringent treatment regimen are sources of psychological distress for patients and present a major challenge for healthcare workers. METHOD: In a cross-sectional study, one hundred and twenty-eight Type 2 diabetic patients were investigated for depression using the Zung Depression Scale. All cases were diagnosed by a physician and patients were selected from outpatient clinics of the four major hospitals in Trinidad. The Pearson product-moment correlation coefficient, stepwise multiple regression and t-test were utilized to examine the relationship between participant's age, gender, glucose control, coexisting medical complications and depression. RESULTS: The patients were primarily Indo-Trinidadians (49%), over 50 years (79.7%) and women (60%). The prevalence of depression was 17.9% of Type 2 diabetic patients reporting mild to moderate levels of depression. Female Type 2 diabetics had higher scores of depression (M = 42.13, SD = 9.83, p = 0.011) than male Type 2 diabetics (M = 38.71, SD = 8.9). Patients with coexisting medical complications had higher levels of depression (M = 44.01, SD = 9.52) than those with diabetes alone (M = 37.74, SD = 8.79, p = 0.000). CONCLUSION: The prevalence of depression in Type 2 diabetic patientS highlights the necessity for psychological screening at diabetic health clinics in Trinidad and Tobago, particularly for women and those with co-morbid medical complications. This will aid in better control, quality of life and longevity.
Assuntos
Depressão/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/psicologia , Idoso , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Trinidad e Tobago/epidemiologiaRESUMO
OBJECTIVE: Cannabis use increases the risk for psychosis, but psychotogenic effects of cannabis may be restricted to exposure during early adolescence. METHOD: Four hundred and seventy-two participants (aged 12-23 years), randomly selected from the general population in Trinidad, completed questionnaires on past and current cannabis use and psychotic symptoms (using the Community Assessment of Psychic Experiences). RESULTS: Cannabis use increased the risk of experiencing psychotic symptoms and this effect was conditional on early exposure, defined around the mean age of onset of cannabis use. Thus, exposure before but not after the age of 14 years predicted psychotic symptoms (respectively beta: 0.71, 95% CI 0.22; 1.19, P = 0.004 and beta: -0.11, 95% CI -0.57; 0.36, P = 0.66). The developmental effect of cannabis use was independent of use of other drugs or current use of cannabis. CONCLUSION: Early adolescence may be a critical period with regard to the psychotogenic effect of cannabis across geographical settings and ethnic groups.
Assuntos
Comportamento do Adolescente/psicologia , Abuso de Maconha/epidemiologia , Abuso de Maconha/psicologia , Fumar Maconha/efeitos adversos , Transtornos Psicóticos/epidemiologia , Adolescente , Adulto , Fatores Etários , Idade de Início , Criança , Comorbidade , Estudos Transversais , Etnicidade/psicologia , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Masculino , Fumar Maconha/epidemiologia , Valor Preditivo dos Testes , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Fatores de Risco , Autorrevelação , Inquéritos e Questionários , Trinidad e Tobago/epidemiologia , Adulto JovemRESUMO
UNLABELLED: This study investigated gender and ethnic differences in the rate of first contact outpatients with schizophrenia in the setting of a more-urban region (MUR) and a less-urban region (LUR) in Trinidad. In a prospective study, 134 first-contact patients with a diagnosis of schizophrenia were selected from two ecologically different regions. RESULTS: Of this population, 56.7% were of African origin and 32.1% were of Indian descent. Gender differences were significant, with males accounting for 66.4% (n=89) of patients with schizophrenia (chi2 = 14.45, d.f. = 1, p = 0.0001). Further analysis by age categories revealed a significant male predominance at ages 20-24 (p = 0.0001) and 25-29 (p = 0.002). Young African males (15-19 y, p = 0.049) predominated in MUR compared with LUR. The results showed a marked presence of Afro-Trinidadian males in both outpatient clinics (p < 0.05). We conclude that gender and ethnicity are important variables in the presentation of schizophrenia in Trinidad, whereas neither rural nor urban environments appeared to influence the expression of schizophrenia.
Assuntos
Serviços de Saúde Mental/estatística & dados numéricos , Saúde da População Rural/estatística & dados numéricos , Esquizofrenia/etnologia , Saúde da População Urbana/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Área Programática de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Esquizofrenia/epidemiologia , Fatores Sexuais , Trinidad e Tobago/epidemiologiaRESUMO
This study investigated gender and ethnic differences in the rate of first contact outpatients with schizophrenia in the setting of a more-urban region (MUR) and a less-urban region (LUR) in Trinidad. In a prospective study, 134 first-contact patients with a diagnosis of schizophrenia were selected from two ecologically different regions. Results: Of this population, 56.7 per cent were of African origin and 32.1 per cent were of Indian descent. Gender differences were significant, with males accounting for 66.4 per cent (n=89) of patients with schizophrenia (X2 = 14.45, d.f. = 1, p = 0.0001). Further analysis by age categories revealed a significant male predominance at ages 20-24 (p= 0.0001) and 25-29 (p = 0.002). Young African males (15-19 y, p = 0.049) predominated in MUR compared with LUR. The results showed a marked presence of Afro-Trinidadian males in both outpatient clinics (p < 0.05). We conclude that gender and ethnicity are important variables in the presentation of schizophrenia in Trinidad, whereas neither rural nor urban environments appeared to influence the expression of schizophrenia.
Assuntos
Humanos , Esquizofrenia/etnologia , Esquizofrenia/epidemiologia , Esquizofrenia/fisiopatologia , Trinidad e Tobago/epidemiologiaRESUMO
Selten et al (2005) cite two reasons for the increased risk of schizophrenia in Surinamese immigrants to The Netherlands. These are an increased base rate in the Surinamese population and exposure to an urban competitive Dutch society. These findings are of particular interest to researchers in Trinidad and Tobago because both countries share a similar mix of African and East Indian population and historically were simultaneously but independently developed by British and Dutch colonisers.
Assuntos
Adolescente , Adulto , Humanos , Masculino , Meio Ambiente , Humanos , Transtornos Psicóticos , Esquizofrenia , Trinidad e Tobago , Região do CaribeRESUMO
This study--the first of its kind in the English-speaking Caribbean--investigated the efficacy of modified brief family therapy in the treatment of alcoholism. Thirty men were treated with family therapy and milieu therapy and compared with 30 sex- and age-matched patients treated with milieu therapy alone. Follow-up over a period of 1 year showed significant levels of improvement in those treated with family therapy. The treatment group did not revert to their original drinking pattern. This can be attributed to family therapy. Family therapy was brief and involved seeing all significant members for 3 sessions, each session lasting 90 min. The role of family therapy and importance of culture in management of these patients are discussed. Our study confirms that a time-limited problem-solving family therapy approach is of use in these ethnic groups.