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Irritable bowel syndrome (IBS), a disorder of gut-brain interaction, is often comorbid with somatic pain and psychological disorders. Dysregulated signaling of brain-derived neurotrophic factor (BDNF) and its receptor, tropomyosin-related kinase B (TrkB), has been implicated in somatic-psychological symptoms in individuals with IBS. We investigated the association of 10 single-nucleotide polymorphisms (SNPs) in the regulatory 3' untranslated region of neurotrophic receptor tyrosine kinase-2 (NTRK2) kinase domain-deficient truncated isoform (TrkB.T1) and BDNF Val66Met SNP with somatic and psychological symptoms and quality-of-life (QoL) in a cohort from the United States (IBS, n = 464; healthy controls, n = 156). We found that the homozygous recessive genotype (G/G) of rs2013566 in individuals with IBS is associated with worsened somatic symptoms, including headache, back pain, joint pain, muscle pain, and somatization as well as diminished sleep quality, energy level, and overall QoL. Validation using United Kingdom BioBank data confirmed the association of rs2013566 with an increased likelihood of headache. Several SNPs (rs1627784, rs1624327, and rs1147198) showed significant associations with muscle pain in our U.S. cohort. These 4 SNPs are predominantly located in H3K4Me1-enriched regions, suggesting their enhancer and/or transcription regulation potential. Our findings suggest that genetic variation within the 3' untranslated region region of the TrkB.T1 isoform may contribute to comorbid conditions in individuals with IBS, resulting in a spectrum of somatic and psychological symptoms impacting their QoL. These findings advance our understanding of the genetic interaction between BDNF/TrkB pathways and somatic-psychological symptoms in IBS, highlighting the importance of further exploring this interaction for potential clinical applications. PERSPECTIVE: This study aims to understand the genetic effects on IBS-related symptoms across somatic, psychological, and quality-of-life (QoL) domains, validated by United Kingdom BioBank data. The rs2013566 homozygous recessive genotype correlates with worsened somatic symptoms and reduced QoL, emphasizing its clinical significance.
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Síndrome do Intestino Irritável , Polimorfismo de Nucleotídeo Único , Receptor trkB , Humanos , Masculino , Feminino , Receptor trkB/genética , Adulto , Pessoa de Meia-Idade , Síndrome do Intestino Irritável/genética , Fator Neurotrófico Derivado do Encéfalo/genética , Qualidade de Vida , Glicoproteínas de Membrana/genética , Isoformas de Proteínas/genética , Estudos de CoortesRESUMO
INTRODUCTION: People caring for patients with dementia are prone to suffering from burden. Behavioral and psychological symptoms of dementia (BPSD) may have an impact on caregiver burden. In Latin American countries, there is a lack of research on caregiver burden. We aimed to determine which BPSD have the greatest impact on caregiver burden among Peruvian patients with dementia and to compare the effects of BPSD on caregiver burden across different types of dementia. METHODS: A cross-sectional study was conducted on 231 patients living with Alzheimer's dementia (AD), behavioral variant frontotemporal dementia (bvFTD), dementia with Lewy bodies (DLB), and vascular dementia (VD) and their caregivers who attended a Peruvian memory clinic. BPSD were assessed with the Neuropsychiatric Inventory (NPI). Caregiver burden was assessed with the Zarit Burden Inventory. We used analysis of variance to compare the AD, bvFTD, DLB, and VD groups. Correlations between Zarit Burden Inventory and NPI subscale scores were assessed with Spearman's correlation. RESULTS: DLB caregivers had significantly higher levels of burden than the other patient groups (p < 0.05) and higher total NPI scores than caregivers for other patient groups (p < 0.05). bvFTD caregivers had significantly higher total NPI scores than AD and VD caregivers (p < 0.05). Hallucinations, aberrant motor behavior, and apathy were the symptoms most significantly correlated with caregiver burden in those caring for DLB, bvFTD, and AD patients, respectively. CONCLUSION: Neuropsychiatric symptoms are higher in DLB caregivers. Hallucinations, aberrant motor behavior, and apathy are the main symptoms correlated with burden.
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Sobrecarga do Cuidador , Cuidadores , Demência , Humanos , Masculino , Feminino , Peru , Estudos Transversais , Idoso , Demência/psicologia , Pessoa de Meia-Idade , Sobrecarga do Cuidador/psicologia , Cuidadores/psicologia , Testes Neuropsicológicos , Doença por Corpos de Lewy/psicologia , Demência Vascular/psicologia , Doença de Alzheimer/psicologia , Demência Frontotemporal/psicologia , Idoso de 80 Anos ou mais , Efeitos Psicossociais da Doença , Sintomas Comportamentais/psicologiaRESUMO
Introduction: The COVID-19 pandemic left healthcare workers physically and mentally exhausted. Studies demonstrated the increase in psychological and psychiatric pathologies with the pandemic. In this work, the impact of vaccination against COVID-19 on the emotional manifestations and psychological symptoms of workers at a general acute care hospital in the City of Buenos Aires, Argentina was measured. Methods: A descriptive, observational, transversal study and analytical survey was developed in order to assess the impact of vaccination against COVID-19 on hospital workers' emotional demonstrations and psychological symptoms. An inquiry to the hospital personnel, who had received at least one dose of vaccine against COVID-19, was disseminated to know more details about self-perceived psychological symptoms and emotions, and safety to carry their work out, before and after vaccination. Results: 302 responses were obtained; 214 (70%) of those surveyed presented some psychological symptom, mainly anxiety (153-50,6%%), anguish (141-46,7%) and sleep disturbances (132-43,7%). The incidence of all decreased after vaccination and 22,1% (67) reported disappearance of some of those symptoms after it. The feelings of calm and security increased by 8% and 2,6% respectively. In 75% (229) vaccination increased the feeling of security at work. Conclusions: Our study shows how vaccination against SARS-CoV-2 reduced the psychological symptoms presented as a result of the pandemic and increased the feeling of job security.
Objetivo: La pandemia por COVID-19 dejó a los trabajadores de salud agotados física y mentalmente. Estudios demostraron el incremento de patologías psicológicas y psiquiátricas con la pandemia. En este trabajo se midió el impacto de la vacunación contra COVID-19 en las manifestaciones emocionales y síntomas psicológicos de los trabajadores de un hospital general de agudos de la Ciudad de Buenos Aires, Argentina Método: Se desarrolló este estudio descriptivo, observacional, transversal y analítico. Se difundió una encuesta al personal que había recibido al menos una dosis de vacuna contra COVID-19 sobre los síntomas psicológicos y emociones auto percibidos y sobre la seguridad para realizar labores, antes y después de la vacunación. Resultados: Se obtuvieron 302 respuestas; 214 (70%) de los encuestados presentó algún síntoma psicológico, ansiedad (153-50,6%), angustia (14-46,7%) y alteraciones del sueño (132-43,7%). La incidencia de los mismos disminuyó luego de la vacunación y el 22,1% (67) manifestó desaparición de alguno luego de la misma. Los sentimientos de tranquilidad y seguridad se incrementaron en un 8 % y 2,6% respectivamente. En el 75% (229) la vacunación aumentó la sensación de seguridad en el trabajo. Conclusión: En nuestro estudio se evidencia cómo la vacunación contra SARS-CoV-2 redujo los síntomas psicológicos presentados a raíz de la pandemia y aumentó la sensación de seguridad laboral.
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Behavioral disturbances are clinically relevant in patients with dementia, and pharmacological regimens to mitigate these symptoms have provided limited results. Proven to be effective in several psychiatric conditions, electroconvulsive therapy is a potentially beneficial strategy for treating severe agitation due to dementia. Objective: This review aimed to examine the publications on the efficacy, safety and tolerability of electroconvulsive therapy in treating patients with agitation due to dementia. Methods: We performed a systematic analysis on the electroconvulsive therapy to treat patients with dementia and coexisting severe agitation. Articles were classified according to the level of evidence based on methodological design. Patients received an acute course of electroconvulsive therapy, often followed by maintenance intervention. Results: We selected 19 studies (156 patients; 64.1% women; 51-98 years old), which met the inclusion criteria: one case-control study by chart analysis (level of evidence 2); one open-label study (level of evidence 3); three historical/retrospective chart analyses (level of evidence 4); and 14 case series/reports (level of evidence 5). No randomized, sham-controlled clinical trials (level of evidence 1) were identified, which represents the main methodological weakness. Some patients had postictal delirium, cardiovascular decompensation and cognitive changes, lasting for a short time. Conclusions: Overall, patients achieved significant improvement in agitation. However, the main finding of the present review was the absence of methodological design based on randomized and sham-controlled clinical trials. Despite methodological limitations and side effects requiring attention, electroconvulsive therapy was considered a safe and effective treatment of patients with severe agitation and related behavioral disorders due to dementia.
Distúrbios comportamentais são clinicamente relevantes em pacientes com demência, e regimes farmacológicos para mitigar esses sintomas têm proporcionado resultados limitados. Comprovadamente eficaz em diversas condições psiquiátricas, a eletroconvulsoterapia é uma estratégia potencialmente benéfica para o tratamento de pacientes com agitação grave na demência. Objetivos: Esta revisão examina as publicações sobre eficácia, segurança e tolerabilidade da eletroconvulsoterapia no tratamento de pacientes com agitação na demência. Métodos: Realizamos uma análise sistemática da eletroconvulsoterapia no tratamento de pacientes com demência e agitação grave. Os artigos foram classificados quanto ao nível de evidência com base no delineamento metodológico. Os pacientes receberam um curso agudo de eletroconvulsoterapia, frequentemente seguido de manutenção. Resultados: Foram selecionados 19 estudos (156 pacientes; 64,1% mulheres; 5198 anos): um estudo caso-controle desenvolvido com base na análise de prontuários (nível de evidência 2); um estudo aberto (nível de evidência 3); três estudos de análise retrospectiva de prontuários (nível de evidência 4); e 14 séries/relatos de casos (nível de evidência 5). Não foram identificados ensaios clínicos randomizados e controlados com placebo (nível de evidência 1), fator que representa a principal fragilidade metodológica. No entanto, o principal achado da presente revisão consistiu na ausência de desenho metodológico baseado em ensaios clínicos randomizados e controlados com placebo. Em geral, os efeitos colaterais foram transitórios e bem tolerados. Alguns pacientes apresentaram delirium pós-ictal, descompensação cardiovascular e alterações cognitivas por períodos breves. Conclusões: No geral, os pacientes obtiveram melhora significativa na agitação. No entanto, o principal achado da presente revisão foi a ausência de delineamento metodológico baseado em ensaios clínicos randomizados e controlados com placebo. Apesar das limitações metodológicas e dos efeitos adversos, a eletroconvulsoterapia foi considerada um tratamento seguro e eficaz em pacientes com agitação grave e com outros distúrbios comportamentais clinicamente relevantes na demência.
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BACKGROUND: According to the emotion regulation process, situation selection comprises actions that increase or decrease the likelihood of being in contexts that foster a certain type of emotion, positive or negative. This concept is complemented by the social basis theory, which starts with the assumption that the primary ecology of humans is characterized by its social components. Thus, reduced access to social relationships increases cognitive and physiological effort, which leads to a decrease in well-being. PARTICIPANTS AND PROCEDURE: In order to make a joint assessment of both concepts, the study used supervised machine learning models to analyze the associations between selected variables of social support, emotion regulation, coping, and several psychological symptoms (somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism). For this purpose, an Argentine sample (N = 812, M age = 44.35, female = 435) was collected through the Internet, nested cross-validations were performed with 8 different learning algorithms and Shapley values were computed for the predictive models that minimized the test errors. RESULTS: The results showed that adaptive strategies have considerable effects on maladaptive strategies, but they do not have significant effects on symptoms. Contrariwise, social support variables have significant effects on symptoms, while they do not have major effects on maladaptive strategies. CONCLUSIONS: It is concluded that the main function of regulatory flexibility does not appear to be a better adaptation to situations, but rather the maintenance of adequate levels of social support, i.e. emotional support received, perception of available emotional support, and perceived comprehension. Further implications are discussed, and a hypothetical model proposed.
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ABSTRACT Behavioral disturbances are clinically relevant in patients with dementia, and pharmacological regimens to mitigate these symptoms have provided limited results. Proven to be effective in several psychiatric conditions, electroconvulsive therapy is a potentially beneficial strategy for treating severe agitation due to dementia. Objective: This review aimed to examine the publications on the efficacy, safety and tolerability of electroconvulsive therapy in treating patients with agitation due to dementia. Methods: We performed a systematic analysis on the electroconvulsive therapy to treat patients with dementia and coexisting severe agitation. Articles were classified according to the level of evidence based on methodological design. Patients received an acute course of electroconvulsive therapy, often followed by maintenance intervention. Results: We selected 19 studies (156 patients; 64.1% women; 51-98 years old), which met the inclusion criteria: one case-control study by chart analysis (level of evidence 2); one open-label study (level of evidence 3); three historical/retrospective chart analyses (level of evidence 4); and 14 case series/reports (level of evidence 5). No randomized, sham-controlled clinical trials (level of evidence 1) were identified, which represents the main methodological weakness. Some patients had postictal delirium, cardiovascular decompensation and cognitive changes, lasting for a short time. Conclusions: Overall, patients achieved significant improvement in agitation. However, the main finding of the present review was the absence of methodological design based on randomized and sham-controlled clinical trials. Despite methodological limitations and side effects requiring attention, electroconvulsive therapy was considered a safe and effective treatment of patients with severe agitation and related behavioral disorders due to dementia.
RESUMO Distúrbios comportamentais são clinicamente relevantes em pacientes com demência, e regimes farmacológicos para mitigar esses sintomas têm proporcionado resultados limitados. Comprovadamente eficaz em diversas condições psiquiátricas, a eletroconvulsoterapia é uma estratégia potencialmente benéfica para o tratamento de pacientes com agitação grave na demência. Objetivos: Esta revisão examina as publicações sobre eficácia, segurança e tolerabilidade da eletroconvulsoterapia no tratamento de pacientes com agitação na demência. Métodos: Realizamos uma análise sistemática da eletroconvulsoterapia no tratamento de pacientes com demência e agitação grave. Os artigos foram classificados quanto ao nível de evidência com base no delineamento metodológico. Os pacientes receberam um curso agudo de eletroconvulsoterapia, frequentemente seguido de manutenção. Resultados: Foram selecionados 19 estudos (156 pacientes; 64,1% mulheres; 51-98 anos): um estudo caso-controle desenvolvido com base na análise de prontuários (nível de evidência 2); um estudo aberto (nível de evidência 3); três estudos de análise retrospectiva de prontuários (nível de evidência 4); e 14 séries/relatos de casos (nível de evidência 5). Não foram identificados ensaios clínicos randomizados e controlados com placebo (nível de evidência 1), fator que representa a principal fragilidade metodológica. No entanto, o principal achado da presente revisão consistiu na ausência de desenho metodológico baseado em ensaios clínicos randomizados e controlados com placebo. Em geral, os efeitos colaterais foram transitórios e bem tolerados. Alguns pacientes apresentaram delirium pós-ictal, descompensação cardiovascular e alterações cognitivas por períodos breves. Conclusões: No geral, os pacientes obtiveram melhora significativa na agitação. No entanto, o principal achado da presente revisão foi a ausência de delineamento metodológico baseado em ensaios clínicos randomizados e controlados com placebo. Apesar das limitações metodológicas e dos efeitos adversos, a eletroconvulsoterapia foi considerada um tratamento seguro e eficaz em pacientes com agitação grave e com outros distúrbios comportamentais clinicamente relevantes na demência.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Violência , Transtornos MentaisRESUMO
Objective: To describe the demographic characteristics, initial psychiatric diagnoses, and the time to reach a diagnosis of probable behavioral variant frontotemporal dementia (bvFTD) in a public psychiatric hospital in Cali, Colombia. Methods: We retrospectively reviewed the medical records of 28 patients who were diagnosed with probable bvFTD based on a multidisciplinary evaluation that included a structural MRI, neuropsychological testing, functional assessment, and neurological exam. Prior to this evaluation, all patients were evaluated by a psychiatrist as part of their initial consultation at the hospital. The initial consultation included the Neuropsychiatric Inventory and diagnoses based on the DSM-V. Demographics, clinical features, and initial psychiatric misdiagnoses were extracted from clinical records and summarized in the full sample and by gender. Results: The study sample had a mean education of 10.0 years (SD = 4.9) and 68.0% were female. In the full sample, 28.6% were initially diagnosed with dementia, and 71.4% with a psychiatric disorder. The psychiatric diagnosis at initial consultation differed by gender. Women were most likely to be diagnosed with depression (26.3%) or bipolar disorder (26.3%), while the men were most likely to be diagnosed with anxiety (33.3%) or a psychotic disorder (22.2%). Psychotic symptoms were common (delusions, 60.7% and hallucinations, 39.3%), and the pattern of neuropsychiatric symptoms did not differ by gender. Conclusions: This is one of few case series of bvFTD in a Colombian population, where bvFTD is a recognizable and prevalent disorder. In this psychiatric hospital, the majority of patients with bvFTD were initially diagnosed with a primary psychiatric condition. There was a gender difference in psychiatric diagnosis, but not in neuropsychiatric symptoms. In this sample, the rate of psychiatric misdiagnosis, as well as the psychotic symptoms, were higher compared to rates described in other countries. These results highlight the need for interventions to improve bvFTD diagnosis in under-represented populations.
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El objetivo del presente trabajo fue estudiar la salud mental y lo síntomas psicológicos en adultos argentinos en contexto de pandemia por Covid-19. El diseño metodológico aplicado fue no experimental de corte transversal, bajo la modalidad de estudio descriptivo, correlacional y de diferencia de grupos. Se trabajó con una muestra de 931 participantes residentes en diferentes provincias de Argentina de edades comprendidas entre 18 y 84 años (MEDAD = 33.08, DE= 15.28, 52% mujeres, 48% varones). Los resultados informaron diferencias significativas entre la salud mental, los síntomas de depresión, ansiedad e intolerancia a la incertidumbre según las variables sociodemográficas analizadas. Se pudo comprobar que a mayor tiempo en confinamiento, mayores son los síntomas que se presentan relacionados a las variables estudiadas y menor es el estado completo de salud mental. Se corrobora que las variables relacionadas a los síntomas de ansiedad, depresión e intolerancia a la incertidumbre predicen de forma negativa el bienestar psicológico, social y emocional en la población Argentina en contexto de pandemia por COVID-19(AU)
This investigation aimed to study mental health and psychological symptoms in Argentinian adults at Covid-19 pandemic context. The methodological design applied was non-experimental, cross-sectional, under descriptive, correlational and group differencing study modality. The sample was 931 participants residing in different provinces of Argentina, aged between 18 and 84 years old (MEDAD = 33.08, SD = 15.28, 52% female, 48% male).Results reported significant differences between mental health, depression, anxiety and intolerance of uncertainty symptoms, according to the sociodemographic variables analyzed. It was found that the longer the time in confinement, the greater the symptoms appeared related to the variables studied and the lower the complete state of mental health. It is confirmed that the variables related to anxiety, depression and intolerance to uncertainty symptoms, negatively predict the psychological, social and emotional well-being in the Argentinian population under COVID-19 pandemic context(AU)
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Humanos , Adulto , Pessoa de Meia-Idade , Saúde Mental , COVID-19 , Incerteza , PandemiasRESUMO
El aislamiento preventivo a causa de la pandemia por COVID-19 ha provocado un aumento en la prevalencia de síntomas psicológicos y emocionales en población adulta de diferentes países. Los objetivos de esta investigación consistieron en: a) realizar la validación de la versión abreviada del Inventario de Síntoma- v45 para su uso en adultos de la Ciudad de Buenos Aires y Conurbano Bonaerense; y b) describir los factores estresantes y la sintomatología psicológica ante la situación de aislamiento obligatorio. Se administró un cuestionario sociodemográfico y la versión abreviada del Inventario de Síntomas Psicológicos a 430 participantes adultos de Buenos Aires (82% mujeres y 18% varones) con un rango de edad fue de 18 a 63 años, una media de 30 años y un desvío estándar de 10. Las diferentes evidencias obtenidas sugieren que el Inventario de Síntomas abreviado es un instrumento válido y confiable. A través de este Inventario se registró una elevada prevalencia de síntomas asociados especialmente a ansiedad fóbica, ansiedad y depresión. Esta evidencia señala la importancia de programas de evaluación e intervención psicológica para disminuir el impacto psicológico del aislamiento a causa de la COVID-19(AU)
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Humanos , Adulto , Pessoa de Meia-Idade , Estresse Psicológico , COVID-19 , Isolamento SocialRESUMO
O presente estudo buscou analisar a relação entre variáveis sociodemográficas (idade, sexo, número de pessoas que moram juntas, tipo de residência, renda e diagnóstico psiquiátrico prévio), comportamentos relacionados à pandemia (tempo diário de aprendizado sobre o Covid-19 e concordância com medidas de distância social) e aspectos psicológicos relacionados à saúde mental geral (bem-estar psicológico, saúde mental, solidão, ansiedade, estresse e depressão). Este estudo transversal quantitativo foi composto por 543 adultos, com idade entre 18 e 76 anos (M = 37,01; DP = 12,85), em sua maioria mulheres. Foram aplicados questionários sobre comportamentos de isolamento durante a pandemia Covid-19, questionário WHO-5, GHQ-12, UCLA, GAD-7, PSS-10 e CES-D. Os dados foram coletados online em todas as regiões brasileiras. Realizamos análise de regressão linear para cada variável dependente (bem-estar, saúde mental, solidão, ansiedade, estresse e depressão). Os resultados indicam que maior renda, morar em casa e não ter diagnóstico psiquiátrico estão associados a maiores escores de bem-estar. Além disso, essas mesmas variáveis sociodemográficas estão negativamente associadas a maiores escores de solidão, estresse, ansiedade e depressão. Concordar com procedimentos de distanciamento social está associado a melhores indicadores de bem-estar e menores escores de ansiedade e estresse. Nós podemos considerar com base nos resultados que fatores sociais, como o tipo de residência e renda, influenciam na qualidade de vida e refletem diretamente na saúde mental. Quanto ao comportamento durante a pandemia, seguir as medidas de distanciamento social pode reduzir a ansiedade e o estresse, melhorando a sensação de bem-estar. Essas descobertas podem ajudar a formular políticas públicas de saúde preventivas.(AU)
The present study sought to analyze the relationship between sociodemographic variables (age, sex, number of people living together, type of residence, income, and previous psychiatric diagnosis), behaviors related to the pandemic (daily learning time about Covid-19 and agreement with measures of social distance) and psychological aspects related to general mental health (psychological well-being, mental health, loneliness, anxiety, stress, and depression). This quantitative cross-sectional study consisted of 543 adults aged 18 and 76 years (M = 37.01; SD = 12.85), mostly women. Questionnaires on isolation behaviors during the Covid-19 pandemic, WHO-5, GHQ-12, UCLA, GAD-7, PSS-10, and CES-D questionnaires were applied. Data were collected online in all Brazilian regions. We performed linear regression analysis for each dependent variable (well-being, mental health, loneliness, anxiety, stress, and depression). The results indicate that higher income, living at home, and not having a psychiatric diagnosis are associated with higher well-being scores. Furthermore, these same sociodemographic variables are negatively associated with higher loneliness, stress, anxiety, and depression scores. Agreeing with social distancing procedures is associated with better indicators of well-being and lower anxiety and stress scores. Based on the results, we can consider that social factors, such as type of residence and income, influence quality of life and directly reflect mental health. As for behavior during the pandemic, following social distancing measures can reduce anxiety and stress, improving feelings of well-being. These findings can help formulate public preventive health policies.(AU)
El presente estudio buscó analizar la relación entre variables sociodemográficas (edad, sexo, número de personas que conviven, tipo de residencia, ingresos y diagnóstico psiquiátrico previo), conductas relacionadas con la pandemia (tiempo de aprendizaje diario sobre Covid-19 y concordancia con medidas de distancia social) y aspectos psicológicos relacionados con la salud mental en general (bienestar psicológico, salud mental, soledad, ansiedad, estrés y depresión). Este estudio transversal cuantitativo consistió en 543 adultos, con edades entre 18 y 76 años (M = 37.01; DT = 12.85), en su mayoría mujeres. Se aplicaron cuestionarios sobre comportamientos de aislamiento durante la pandemia Covid-19, WHO-5, GHQ-12, UCLA, GAD-7, PSS-10 y CES-D. Los datos se recopilaron en línea en todas las regiones brasileñas. Realizamos análisis de regresión lineal para cada variable dependiente (bienestar, salud mental, soledad, ansiedad, estrés y depresión). Los resultados indican que los ingresos más altos, vivir en casa y no tener un diagnóstico psiquiátrico se asocian con puntajes de bienestar más altos. Además, estas mismas variables sociodemográficas se asocian negativamente con puntuaciones más altas de soledad, estrés, ansiedad y depresión. Estar de acuerdo con los procedimientos de distanciamiento social se asocia con mejores indicadores de bienestar y menores puntuaciones de ansiedad y estrés. Con base en los resultados, podemos considerar que factores sociales, como el tipo de residencia y los ingresos, influyen en la calidad de vida y repercuten directamente en la salud mental. En cuanto al comportamiento durante la pandemia, seguir las medidas de distanciamiento social puede reducir la ansiedad y el estrés, mejorando la sensación de bienestar. Estos hallazgos pueden ayudar a formular políticas públicas de salud preventiva.(AU)
Assuntos
Saúde Mental , Pandemias , COVID-19RESUMO
ABSTRACT The study aimed to investigate the prevalence and effects of premenstrual syndrome (PMS) on the psychological factors of university students who do and do not participate in resistance training. The initial sample consisted of 81 participants, and the prevalence of PMS was 64.2%. Forty women diagnosed with PMS were divided into two groups: women who participated in (GP) and did not participate in (GNP) resistance training. The intergroup comparison showed significant differences (with higher scores in the GNP) in the items: difficulty concentrating, lack of energy, and feeling under pressure, and they reported a greater influence of the symptoms on their family relationships. It is concluded that women who participate in resistance training have reduced indicators of some psychological symptoms of PMS.
RESUMO O estudo objetivou investigar a prevalência e os efeitos da Síndrome Pré-Menstrual (SPM) nos fatores psicológicos de universitárias praticantes e não praticantes de treinamento resistido. A amostra inicial consistiu em 81 participantes, e a prevalência da SPM foi de 64,2%. Quarenta mulheres diagnosticadas com SPM foram divididas em dois grupos: praticantes (GP) e não-praticantes (GNP) de treinamento resistido. A comparação intergrupos apresentou diferenças significativas (com maiores escores do GNP) referentes aos itens: dificuldade de concentração, falta de energia, e sentindo-se sob pressão, tendo maior interferência dos sintomas em seus relacionamentos familiares. Conclui-se que mulheres praticantes de treinamento resistido apresentam indicadores reduzidos de alguns sintomas psicológicos da SPM.
RESUMEN El objetivo fue investigar la prevalencia y los efectos del síndrome premenstrual (SPM) sobre los factores psicológicos de las universitarias que practican y no practican el entrenamiento de resistencia. La muestra inicial consistió en 81 mujeres, y la prevalencia del SPM fue del 64,2%. Cuarenta mujeres diagnosticadas con SPM se dividieron en dos grupos: practicantes (GP) y no practicantes (GNP) de entrenamiento de resistencia. La comparación intergrupal mostró diferencias significativas (con puntajes de GNP más altos) con respecto a: dificultad para concentrarse, falta de energía y sentirse bajo presión, con una mayor interferencia de síntomas en sus relaciones familiares. Las mujeres que practican el entrenamiento de resistencia han reducido los indicadores de algunos síntomas psicológicos del SPM.
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The number of people with dementia worldwide is expected to increase to approximately 1.3 billion in 2050. Almost 90% of patients diagnosed with dementia suffer from behavioral and psychological symptoms of dementia (BPSD). BPSD causes and risk factors are multiple and complex and can be responsible for hospitalizations in long-term institutions, psychiatric hospitalizations and search for health services. Recently, the world imposition of social distance and self-isolation as the best preventive measures for the COVID-19 pandemic has created challenges in the health care and management of this population, which may trigger or aggravate BPSD, and most caregivers are not prepared to address it. In face of this actual social distancing, telemedicine comes to be a tool for improving the management of these acute symptoms and mental care. In this article, we discuss and disseminate recommendations on this important alternative of assistance, especially considering the cases of BPSD. In this context of a pandemic, even patients with BPSD and caregivers require more frequent and updated guidance, considering the difficult context to social distance. Telemedicine can reduce the risk for the development of negative outcomes in mental health precipitated by the reduction of social contact and less access to health services, improving dementia symptom management, mainly BPSD.
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BACKGROUND: Behavioral and psychological symptoms (BPSD) can be a prodrome of dementia, and the Neuropsychiatric Inventory (NPI) is widely used for BPSD evaluation. OBJECTIVE: To compare the prevalence of BPSD according to cognitive status, and to determine NPI cutoffs that best discern individuals with mild cognitive impairment (MCI) and dementia from those without dementia. METHODS: We included 1,565 participants (mean ageâ=â72.7±12.2 years, 48% male). BPSD and cognitive status were assessed with the NPI and the Clinical Dementia Rating (CDR). We used multivariable logistic regression models to investigate the association of BPSD with cognitive status. The area under the curve (AUC) was used to assess model discrimination, and to determine the best NPI cutoff for MCI and dementia. RESULTS: Participants were cognitively normal (CDRâ=â0; nâ=â1,062), MCI (CDRâ=â0.5; nâ=â145), or dementia (CDR≥1.0, nâ=â358). NPI symptoms were more frequent in dementia and MCI when compared to cognitively normal. Higher odds for delusions, hallucinations, disinhibition, and psychomotor alterations were found among participants with dementia and MCI than in those who were cognitively normal. The best NPI cutoff to discern participants with dementia from those cognitively normal was 11 (AUCâ=â0.755). Poor discrimination (AUCâ=â0.563) was found for the comparison of MCI and those cognitively normal. CONCLUSIONS: We found an increase in BPSD frequencies across the continuum of cognitive impairment. BPSD severity and frequency in MCI was more similar to individuals cognitively normal than with dementia. NPI scores≥to 11 in individuals with no diagnosis of dementia can support the decision for further investigation of dementia.
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Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Idoso , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/patologia , Cognição , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/patologia , Estudos Transversais , Diagnóstico Diferencial , Feminino , Humanos , Vida Independente , Masculino , Testes Neuropsicológicos , Prevalência , Escalas de Graduação PsiquiátricaRESUMO
INTRODUCTION: This study analyzes the prevalence of malnutrition, depression, anxiety, and somatization and which factor has the biggest effect on quality of life (QoL) in individuals with resected cancer. METHODS: A prospective study was conducted among 747 participants. Participants completed the EORTC-QLQ30, MST, and BSI-18 questionnaires. RESULTS: Prevalence for risk of malnutrition, depression, anxiety, and somatization were 36.4%, 35.5%, 35.2%, and 48.8%, respectively. Hierarchical multiple regression analyses revealed that malnutrition risk, somatization, depression, and anxiety accounted for 50.8% of the variance in functional scale, 45.3% in symptom scale, and 52.2% in global health. Malnutrition, somatization, depression, and anxiety displayed high explanatory power on all health-related QoL (HRQoL) scales. CONCLUSION: The risk of malnutrition and psychological symptoms is strongly associated with HRQoL in cancer patients; thus, medical oncologists should develop effective interventions that contribute to lowering the risk of malnutrition and psychological distress, thereby improving subjects' HRQoL before initiating adjuvant chemotherapy.
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Ansiedade/epidemiologia , Depressão/epidemiologia , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Desnutrição/epidemiologia , Neoplasias/cirurgia , Qualidade de Vida , Estresse Psicológico/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Estudos Transversais , Depressão/etiologia , Feminino , Seguimentos , Humanos , Masculino , Desnutrição/etiologia , Pessoa de Meia-Idade , Prevalência , Prognóstico , Estudos Prospectivos , Fatores de Risco , Espanha/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e QuestionáriosRESUMO
Abstract Background To better understand the trends of behavioral and psychological symptoms of dementia (BPSD) over the disease progression is important to provide psychoeducation for dementia caregivers. Objective This study examined the severity and occurrence of BPSD across the various degrees of the disease. Methods This study was a cross-sectional design. Patients (N = 276) who had dementia from July 2001 to October 2008 were surveyed and assessed for dementia stage, using the clinical dementia rating scale (CDR). BPSD was evaluated using the Neuropsychiatric Inventory (NPI). We examined the differences between the severities and occurrence of the individual's BPSD among various CDR stages with the Kruskal-Wallis test and Chi-square test. Results Delusion (p = 0.01), agitation/aggression (p = 0.033), apathy/indifference (p = 0.009), aberrant motor behavior (p < 0.001), nighttime behavior disturbances (p < 0.001), and eating abnormalities (p = 0.001) were significantly different among stages of dementia. The severity of BPSD became exacerbated over the course of the disease, and was highest in moderate (CDR = 2) or severe (CDR = 3) dementia. The occurrence of BPSD was highest when the CDR equaled 2 (97.5%). Discussion The association of global (or certain) BPSD, across different stages of dementia, is a non-linear relationship. These findings suggest the importance of taking into account clinical dementia stage for managing BPSD.
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RESUMO Objetivo Construir e validar a Escala de Identificação de Sintomas Psicopatológicos em Escolares (EISPE). Métodos Trata-se de um estudo metodológico, realizado seguindo-se procedimentos teóricos: painel de juízes e estudo-piloto; experimentais, por meio de coleta com 201 crianças de seis a 12 anos; e estatísticos, com validação de construto testada por meio do Modelo Rasch e alfa de Cronbach. Resultados Na análise do painel de juízes quanto a clareza e representatividade, cinco itens foram excluídos e, após o teste-piloto, um item foi excluído, chegando a uma versão preliminar da EISPE de 23 itens, avaliando seis aspectos. O Modelo Rasch apresentou a EISPE como unidimensional, com a maior parte dos itens ajustados ao modelo, exceto quatro deles que apresentaram valores de correlação item-total abaixo de 0,2, e outros dois que apresentaram funcionamento diferencial conforme o sexo das crianças: A confiabilidade dos itens foi 0,97, e o valor do alfa de Cronbach, de 0,67. Conclusão A versão preliminar da EISPE apresentou qualidades psicométricas satisfatórias, o que sugere que esta é confiável para identificar sintomas psicopatológicos relacionados a ansiedade, humor, condutas sociais, atenção/atividade motora, padrões alimentares e uso/abuso de substâncias psicoativas em crianças com idades entre seis e 12 anos.
ABSTRACT Objective To construct and validate the Scale for the Identification of Psychopathological Symptoms in Schoolchildren (SIPSS). Methods This methodological study was based on the following theoretical procedures: panel of judges and pilot study; experimental procedures for collecting data from 201 children aged from six to 12 years old; statistical procedures including construction validation, tested using the Rasch model and Cronbach's alpha. Results Analysis by the panel of judges resulted in the exclusion of five items. Another item was also discarded after the pilot test, resulting in a preliminary version with 23 items assessing six aspects. The Rasch model indicated that the SIPSS is a one-dimensional scale and most items are adjusted to the model, except four items that presented an item-total correlation below 0.2 and two items that presented differential functioning depending on the children's sex: reliability of items was 0.97 and Cronbach's alpha was - 0.67. Conclusion The scale's preliminary version presented satisfactory psychometric properties, suggesting it is reliable for the identification of psychopathological symptoms related to anxiety, mood, social behavior, motor attention/activity, eating patterns, and the use/abuse of psychoactive substances among children aged from six to 12 years old.
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AIM: To investigate the effects of the Staff Training for Assisted Living Residences administered to formal caregivers of older adults with behavioral and psychological symptoms of dementia in the institutional environment. METHODS: The project was developed in two long-term care institutions in Belo Horizonte, Brazil, with 25 formal caregivers and 46 older adults with dementia. The training was carried out over 6 weeks. Evaluations were carried out with the caregivers and the elderly residents, using specific instruments to evaluate different domains (demographic data, etiological diagnoses of dementia, severity of dementia, global cognition, functional performance, quality of life, behavior, burden of caregiver, depression and anxiety). The total time for data collection was 6 months. RESULTS: A significant improvement in behavioral and psychological symptoms of dementia, as assessed by the Neuropsychiatric Inventory, was observed (P < 0.008), with no changes in the other indexes. No significant changes were observed in parameters related to caregivers. CONCLUSIONS: The Staff Training for Assisted Living Residences protocol was effective in reducing neuropsychiatric symptoms in dementia patients, and might be a feasible and positive strategy to train formal caregivers in long-term care institutions in Brazil. Geriatr Gerontol Int 2017; 17: 449-455.
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Moradias Assistidas , Cuidadores/educação , Demência/enfermagem , Equipe de Assistência ao Paciente/organização & administração , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Feminino , Avaliação Geriátrica , Humanos , Assistência de Longa Duração , Masculino , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Estatísticas não ParamétricasRESUMO
En Colombia el virus del chikungunya (CHIKV) ha causado muchos enfermos, sobre todo en Atlántico, Magdalena y Sucre. El objetivo de esta investigación es examinar las variables psicológicas presentes en pacientes que hayan sido diagnosticados con este virus. Se entrevistó a 63 personas (41 mujeres, 65,1 %) con el cuestionario general de salud mental de Goldberg y con un instrumento basado en otro, recientemente desarrollado por un equipo de investigación de la isla Mauricio. A partir de este instrumento se exploraron los síntomas presentados por el CHIKV. El 50 % de la muestra consideró que el virus alteró su estado emocional. Se halló insomnio, irritabilidad, y/o tristeza. Los hombres sintieron más irritabilidad que las mujeres (p = .003). Las autoridades de salud podrían tener en cuenta esta información a la hora de tratar a estos pacientes
Chikungunya Virus (CHIKV) has caused many patients in Colombia, especially in Atlantico, Magdalena and Sucre. The aim of this research was to examine the psychological variables in patients who have been diagnosed with CHIKV. We interviewed 64 people (41 women, 65.1 %) with an instrument developed by a research team from India and with the Goldberg's General Mental Health Questionnaire. From this first instrument were explored the symptoms caused by CHIKV. Of the sample, 50 % perceived that CHIKV affected their emotional state. Insomnia, irritability and/or sadness were found in people suffering by CHIKV. Men showed more irritated than women (p= .003). Health authorities should take this information into account when treating these patients
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BACKGROUND: First longitudinal studies in prisoners point to improvements of depressive symptoms during imprisonment. The aim of the present study was to assess the course of major depressive disorder during imprisonment and to identify factors influencing remission. METHODS: Prisoners with major depressive disorder in a sample of consecutive admissions to the penal justice system in Santiago de Chile were reassessed after one year of imprisonment. Psychiatric diagnoses were established using the Mini-International Neuropsychiatric Interview; psychological symptoms were assessed with the Symptom-Check-List 90 Revised (SCL-90-R). Mean symptom scores were compared at baseline and follow-up using Student's t-test. Odds ratios (OR) of comorbid disorders and socio-demographic factors at baseline to predict depression at follow-up were calculated. RESULTS: N=79 out of 80 inmates (99%) with major depression at baseline were included. Thirty-five prisoners (44%) had major depression at follow-up. The mean global severity score and all mean subscale scores of the SCL-90-R improved. High suicide risk was present in 37 prisoners (47%) at admission and in 11 (14%) at follow-up. The comorbid diagnosis of PTSD (OR 6.3; p<0.001) at admission and having been previously imprisoned (OR 2.5; p=0.05) predicted major depressive disorder at follow-up. LIMITATIONS: The study could not account for temporary improvements between the assessments. CONCLUSION: In spite of important symptom improvements, only about half of the prisoners with major depression at admission remit after one year of imprisonment. New interventions should target people with major depression and comorbid PTSD at admission.