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The purpose of the study was to determine how Adverse Childhood Experiences (ACE) relate to adulthood flourishing, symptoms of depression, anxiety, somatization, self-reported health, sexual risk behaviors, and alcohol consumption. A quantitative cross-sectional methodology was used. A total of 452 adults completed the survey. The most prevalent ACE include physical abuse (44.69%), separation/divorce of parents (41.81%), living with someone with alcohol problems (39.38%), and being sworn, insulted, or humiliated by adults at home (35.62%). Almost one out of every four respondents (24.34%) reported being touched by an adult, 17.92% reported that an adult tried to manipulate the respondent into touching them, and 8.19% were forced to have sexual intercourse. Results indicate that women reported a higher number of ACE than men. The number of ACE is inversely related to flourishing and self-reported health; while being positively associated with participant's scores in depression, anxiety, somatization, sexual risk behaviors, and alcohol use. The regression model, including the eleven ACE and respondents' sex and age, achieved medium effect sizes for somatization, depression, and anxiety symptoms and small effect sizes for flourishing, self-reported health, sexual risk behaviors, and alcohol consumption. Specific ACE have a particularly significant negative impact on mental health outcomes: forced intercourse, witnessing familial violence, verbal humiliation, and living with individuals struggling with mental health issues and drug consumption or who were incarcerated. In conclusion, the study highlights the alarming prevalence of ACE among the Honduran population and their significant negative impact on mental health outcomes during adulthood.
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BACKGROUND: The extent to which depression is associated with somatic complaints in children from the English-speaking Caribbean and Latin America is not well established. OBJECTIVE: We sought to explore the association between depressive and somatic symptoms among children from the English-speaking Caribbean and Latin America, while accounting for age, sex, socioeconomic status, cultural background, and anxiety score. METHOD: 1541 elementary school children, ages 9-12 years, from the English-speaking Caribbean and Latin America completed the Adolescent Depression Rating Scale (ARDS), the Numeric 0-10 Anxiety Self-Report Scale and the Children's Somatic Symptom Inventory-24 (CSSI-24). T-tests and ANOVA's were used to compare CSSI-24 and ARDS scores among countries, and the CSSI-24 scores of children with (ARDS ≥ 4) and without likely clinically significant depression. Regression analyses assessed possible predictors of CSSI-24 score. RESULTS: Depressive and somatic symptom scores were highest among the Jamaican children and lowest among the Colombian children (p < .001). Children with likely clinically significant depression exhibited higher mean somatic symptom scores (p < .001). Depressive symptom scores predicted somatic symptom scores (p < .001). CONCLUSIONS: Depressive symptoms were a strong predictor of reporting somatic symptoms. Knowledge of this association may facilitate better recognition of depression among youth.
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Sintomas Inexplicáveis , Síndrome do Desconforto Respiratório , Adolescente , Criança , Humanos , América Latina/epidemiologia , Depressão/epidemiologia , Região do Caribe/epidemiologiaRESUMO
Introducción: Los trastornos mentales comunes se refieren a una variedad de afecciones de salud mental no psicóticas, como la depresión, ansiedad y manifestaciones somáticas, que son reconocidas en la actualidad como un problema de salud pública debido a las repercusiones en la salud de las personas que lo padecen. Objetivo: Estimar la prevalencia de los trastornos mentales comunes en estudiantes de la carrera profesional de Enfermería de una universidad pública. Método: El enfoque de investigación fue cuantitativo, el diseño no experimental de tipo descriptivo-comparativo de corte transversal. La población estuvo conformada por 321 estudiantes y la muestra por 175 estudiantes, quienes respondieron al Self Reporting Questionnaire-SRQ 20, instrumento con adecuados niveles de validez y confiabilidad. Los datos se procesaron a través del software SPSS versión 25. Para el análisis se utilizó la estadística descriptiva y para determinar si los trastornos mentales comunes se asociaban a las variables sociodemográficas propuestas, se recurrió a la prueba no paramétrica ji cuadrado. Resultados: La prevalencia general de los trastornos mentales comunes fue del 39,4 por ciento. Asimismo, se determinó que la prevalencia se asociaba de manera significativa al sexo y al nivel de consumo de bebidas alcohólicas (p< 0,05). Conclusiones: Existe una prevalencia moderada de los trastornos mentales comunes en los estudiantes peruanos de Enfermería(AU)
Introduction: Common mental disorders refer to a variety of non-psychotic mental health conditions, such as depression, anxiety, and somatic manifestations that are currently recognized as a public health problem due to the repercussions on the health of the people who suffer from them. Objective: To estimate the prevalence of common mental disorders among Nursing students at a public university in the Peruvian Amazon. Method: The research approach was quantitative, the design, non-experimental and the type, descriptive-comparative cross-sectional. The population consisted of 321 students and the sample by 175 students who responded to the Self Reporting Questionnaire-SRQ 20, an instrument with adequate levels of validity and reliability. The data was processed through the SPSS version 25 software. For the analysis, descriptive statistics were used and to determine if the common mental disorders were associated with the proposed sociodemographic variables, the non-parametric Chi-Square test was used. Results: The overall prevalence of common mental disorders was found to be 39.4 percent. Likewise, it was determined that the prevalence was significantly associated with gender and the level of consumption of alcoholic beverages (p< 0.05). Conclusions: There is a moderate prevalence of common mental disorders in Peruvian Nursing students(AU)
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Humanos , Masculino , Feminino , Adolescente , Adulto , Ansiedade , Transtornos Somatoformes , Transtornos Mentais/epidemiologia , Consumo de Bebidas Alcoólicas/epidemiologia , Epidemiologia Descritiva , Estudos Transversais , Educação em EnfermagemRESUMO
Approximately one out of ten COVID-19 cases in Ecuador was a physician. It has been reported that this situation has led to a serious detriment of physicians' health and well-being. This study aimed to (i) identify predictors of emotional exhaustion, somatization, and work alienation in Ecuadorian physicians working with COVID-19 patients and (ii) explore the pandemic impact on doctor-patient relationships and on empathy. In 79 Ecuadorian physicians (45 women) who worked with COVID-19 patients, two separate multiple regression models explained the following: 73% of the variability of emotional exhaustion was based on somatization, work alienation, working sector, and passing through a symptomatic infection (p < 0.001), and 56% of the variability of somatization was based on gender and emotional exhaustion (p < 0.001), respectively. Furthermore, intention to leave the profession was more frequent among physicians with greater work alienation (p = 0.003). On the contrary, more empathic physicians never considered leaving their profession during the COVID-19 pandemic (p = 0.03). In physicians' verbatim, cognitive empathy appeared associated to a positive change in doctor-patient relationships. On the contrary, having an overwhelming emotional empathy appeared associated to a negative change in doctor-patient relationships. These findings characterize differences in how physicians cope while working in the frontline of the pandemic.
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Resumen A pesar de que la violencia de pareja íntima (VPI) presenta en la mujer una variedad de síntomas evidenciables, varios de los actores involucrados en el sistema de salud no cuentan con mecanismos de evaluación temprana, ni de reconocimiento de los tipos de secuelas psicológicas, entre los que se incluye una diversa sintomatología psicofisiológica. Con el objetivo de conocer las características de somatización, ansiedad y depresión en mujeres víctimas de VPI, como parte de una investigación macro de corte transversal no experimental de campo, se realizó el presente estudio cuantitativo correlacional a través de las variables del Inventario de Evaluación de la Personalidad (PAI). Los datos obtenidos se sometieron a análisis estadístico con métodos descriptivos e inferenciales. La muestra consta de 50 mujeres de la población de víctimas de VPI de la sierra ecuatoriana. Los resultados obtenidos son bastante contradictorios en cuanto al bajo porcentaje de mujeres con afectación típica relacionada con este tipo de violencia, en comparación con los datos presentados por otros autores sobre los niveles de somatización, ansiedad y depresión en ellas. A pesar de esto, se obtuvieron tres factores independientes presentes en esta muestra: trastorno ansioso-depresivo, con elementos de estrés postraumático; trastorno obsesivo compulsivo, con elementos de ansiedad, y quejas somáticas. Al momento de finalizar este estudio, se puede concluir que el PAI, sin su validación previa en esta población, no muestra una idoneidad suficiente para evaluar mujeres víctimas de VPI en el Ecuador. Se recomiendan nuevas investigaciones en otras muestras, en las que se utilicen diversos esquemas empíricos que incluyan varios instrumentos y medios cualitativos.
Abstract Various studies have noticed that women victims of intimate partner violence (IPV) also report having various types of health-related problems. However, health systems do not appear to have established procedures to recognize these problems (i. e., psychophysiological) in women. This study assessed somatic symptoms, anxiety, and depressive characteristics in women who have been victims of IPV. These symptoms were assessed using the scales of the Personality Assessment Inventory (PAI). The sample consisted of 50 women victims of IPV from the Ecuadorian sierra. Group participants came from two different cities: the first group included 28 women victims of IPV from Riobamba. Their ages ranged from 15 to 58. These women were receiving psychological services from a not-for-profit organization in the city. The second group included 22 women with similar characteristics between the ages of 27-63. This group of women came from the southern regions of Quito, the capital city of Ecuador. Women in this group were receiving services from two different places offering help to women experiencing IPV. Sixteen percent of women reported having a medium level of "anxiety" (some level of stress), and 14 % reported having a high level of tension and stress. Thirty-four percent of women reported medium levels of "anxiety-related disorders". These women reported having specific fears, little confidence in themselves and negative perspectives of their future. Sixteen percent of the women reported high levels of anxiety. They reported imitations in daily life (i. e., specific fears and feelings of insecurity in social situations). Thirty percent of women reported having medium levels of "depression" (sensitivity, pessimism, and feeling unhappy part of the time). Eighteen percent of women reported having high levels of "depression" (notable unhappiness and dysphoria). Forty-four percent of women in this study reported having some type of physical problem. These findings suggest that women who are victims of IPV could benefit from receiving mental health services aimed at managing their tension, stress, specific fears, and symptoms of depression. They also suggest that women victims of IPV could benefit from receiving training to increase their social competency and medical assistance to address their somatic complaints. Findings in this study are somewhat divergent from the results observed in previous investigations. Previous studies identified that most women who experienced IPV report symptoms of depression and anxiety. However, in this study, only a relatively low percentage of women reported having these symptoms. The sole utilization of the PAI as a method of evaluation may not have been sufficient to identify these symptoms. These results suggest the importance of using qualitative methods (i. e., clinical interview) or more holistic methodologies (i. e., clinical interview and tests) to better assess mental health symptoms in this group of women. It is also possible that the PAI might not be the most adequate tool to assess these symptoms in this population. The results of this investigation do reveal the importance of evaluating other mental health symptoms in women victims of IPV: post-traumatic stress, and obsessive-compulsive disorder. Future studies should focus on assessing these symptoms using other assessment methodologies (e. g. instruments designed to assess post-traumatic stress and obsessive-compulsive disorder). The efficiency of health systems evaluations and interventions depends on the methodologies used to assess problems. The sole use of one instrument such as the PAI may not provide sufficient information about symptoms experienced by women experiencing IPV. Health systems should use batteries of instruments in conjunction with the clinical interviewing processes to readily assess symptoms. However, such an alternative may not be entirely feasible taking into account that such methodology requires more time and likely financial support to acquire tests.
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The objective of the study is to determine the personal, behavioral and psychological variables associated with somatization and the number of diseases in each gender from a sample of Mexican general population. They answered a questionnaire of behavioral and psychological variables including somatization and the sum of 16 different diseases and any additional one, finally the body mass index (BMI) was measured. A total of 164 participants (women = 90, men = 74) were included. We observed that women had more somatization and number of diseases than men and that more variables (mainly psychological) were associated with somatization and with the number of diseases in women than in men. Among the variables most negatively correlated in women with both variables were sleep quality (r = -0.525 and r = -0.536, p < 0.001), self-acceptance (r = -0.460 and r = -0.501, p < 0.001), positive relations with others (r = -0.447 and r = -0.441 p < 0.001), environmental mastery (r = -0.414, p < 0.001, for both variables), purpose in life and optimism; while men only showed a low negative correlation between emotion regulation and the number of diseases (r = -0.289, p < 0.05). The positive associated variables in women were anxiety, negative emotions and depression; while men showed a lower correlation between these three variables only with somatization. The somatization and age were positively related to the number of diseases in both genders and the BMI was significantly associated with the number of diseases only in men. In conclusion, women had more somatization and number of diseases than men and also had more relation between psychological variables and the two dependent variables than men, which could in part explains the higher values of somatization and the number of diseases in women, considering that they usually present higher values of psychopathological variables.
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Ansiedade , Depressão , Humanos , Masculino , Feminino , Ansiedade/epidemiologia , Depressão/epidemiologia , Depressão/psicologia , Transtornos de Ansiedade , Inquéritos e QuestionáriosRESUMO
The COVID-19 pandemic had a strong impact on mental health. Multiple studies report the alarming prevalence of depression, anxiety, and stress-related conditions due to the lockdown measures. Nevertheless, somatization has been an overlooked topic in current literature despite its strong relationship with most mental health conditions. The aim of this study was to describe the prevalence of somatic symptoms and their associated factors in a sample of 3218 undergraduate students from Lima, Peru. A cross-sectional design was carried out. The prevalence of somatic symptoms was measured with the PHQ-15. As predictors of somatic symptom severity, we included psychopathological (depression, anxiety, and stress), psychological (perceived social support, resilience, satisfaction with life, and academic self-efficacy), and sociodemographic (e.g., age, sex, employment status, relationship status, daily hours of sleep) variables. A generalized linear model from a binomial family and a logit link function were applied based on a Factor Score Regression approach, with half of the sample presenting moderate-to-severe somatic symptoms. Anxiety was the strongest predictor of somatic symptom severity, followed by academic self-efficacy. Significant differences were found regarding sex, relationship status, daily hours of sleep and COVID-19 risk-related variables. In conclusion, interventions on reducing anxiety and promoting academic self-efficacy may have a stronger impact on somatic symptom severity and should focus on more vulnerable specific demographic groups such as females.
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COVID-19 , Feminino , Humanos , COVID-19/epidemiologia , COVID-19/psicologia , Pandemias , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Controle de Doenças Transmissíveis , Ansiedade/epidemiologia , Ansiedade/psicologiaRESUMO
Somatization and number of diseases are interrelated variables, whose association with stress-coping strategies, according to sex, has not been investigated. Therefore, the aim of this study was to investigate such association in a sample of the Mexican general population. The general population was invited to answer an electronic questionnaire via the social networks-e-mail, WhatsApp and Facebook-by the research team. A sample of 1008 adults was obtained, of which 62.2% were women, in whom we detected higher levels of negative psychological variables, somatization and number of diseases and lower levels of sleep quality. Positive moderate correlations were found between depresion, anxiety and stress with somatization, on one hand, and with the number of diseases, on the other, and negative moderate correlations were found between sleep quality and the two dependent variables. As for the coping strategies, self-blame, behavioral disengagement, denial, self-distraction and substance use were positively correlated with somatization. Of these, self-blame, substance use, and self-distraction also showed a positive correlation with number of diseases in both sexes. Negative correlations were detected for active coping and the two dependent variables in men and for religion and planning with somatization in women. In conclusion, the coping strategies showed significant correlations with somatization and number of diseases in both sexes.
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The identification of general population groups particularly vulnerable to the impact of COVID-19 lockdown measures on mental health and the development of healthcare policies are priority challenges in the current and future pandemics. This study aimed to identify the personal and social determinants of the impact of COVID-19 lockdown measures on mental health in a large sample of the Colombian population. In this cross-sectional study, an anonymous online survey was answered by 18,061 participants from the general population residing in Colombia during the first wave of the COVID-19 outbreak (from 20 May to 20 June 2020). The risk of depression, anxiety, and somatization disorders were measured using the Patient Health Questionnaire (PHQ-2), Generalized Anxiety Disorder Scale (GAD-2), and Somatic Symptom Questionnaire (SSQ-5), respectively. Overall, 35% of participants showed risk of depression, 29% of anxiety, and 31% of somatization. According to the analysis of social determinants of health, the most affected groups were people with low incomes, students, and young adults (18-29 years). Specifically, low-income young females were the most at-risk population group. These findings show how the lockdown measures affected the general population's mental health in Colombia and highlight some social risk factors in health.
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BACKGROUND: Temporomandibular disorders (TMD) are related to psychological factors. Adolescence is one of the stages in life with more psychosocial vulnerability, which is dissimilar in rural and urban zones. Thus, the aim of this investigation was to evaluate the association between psychological factors (symptoms of anxiety, depression and somatization) and TMD in adolescents between 12 and 15 years, belonging to urban and rural zones of Colombia. METHODS: 180 subjects aged 12-15 years (mean 13.8, SD 1.2), enrolled in public schools in the rural (n = 90) and urban (n = 90) zones were included. All subjects were evaluated using the DC/TMD instrument; the Axis I was applied for the clinical examination and the Axis II for the psychological evaluation. Data were analyzed by means of T-student, Mann-Whitney, Kruskall-Wallis tests, Pearson Chi square and multiple-variable analysis with logistic regression. RESULTS: Forty percent of the included subjects presented some type of TMD. TMD related to pain were the most common (25.5% of the studied adolescents), being myalgia the most common (20% of the adolescents in urban zone and 31.1% of the adolescents in the rural zone). There was no difference between the TMD present in males and females, but there were differences in the symptoms of Anxiety, and Somatization (p < 0.05). TMD and psychological factors were more prevalent in children with 13 years of age. A statistically significant association between TMD and symptoms of Anxiety (Pearson Chi squared 25.57, p = 0.04), depression (Pearson Chi squared 33.28, p = 0.03) and somatization (Pearson Chi squared 25.79, p = 0.04) was found in subjects from rural zones. No associations between psychological aspects and TMD were found in subjects from urban zones, but overall all psychological factors significantly influenced TMD. CONCLUSION: This study indicates Myalgia to be the most prevalent TMD in studied Colombian adolescents. Pain-related TMDs are associated with psychological factors in the adolescent population of rural Colombia. Symptoms of anxiety, depression and somatization were found to be associated to TMD, even when the frequency was not necessarily severe.
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Depressão , Transtornos da Articulação Temporomandibular , Adolescente , Ansiedade/epidemiologia , Criança , Colômbia/epidemiologia , Depressão/epidemiologia , Feminino , Humanos , Masculino , Dor , Transtornos da Articulação Temporomandibular/epidemiologiaRESUMO
OBJECTIVE: To assess the frequency of somatization and its association with motor, nonmotor symptoms, and quality of life in persons with Parkinson disease (PD). METHODS: A cross-sectional case-control study was carried out. Assessments included the List of 90 Symptoms somatic factor (SCL-90-R SOM), Movement Disorder Society Unified Parkinson's Ratings Scale (MDS-UPDRS), Non-Motor Symptom Scale (NMSS), Montreal Cognitive Assessment (MoCA), and Parkinson Questionnaire-8 (PDQ-8). RESULTS: A total 93 persons with PD and 93 controls were included. Somatization within the PD group was 2 times more frequent compared to the control group (43% vs 21.5%, P = .003). Persons with PD had higher NMSS total scores (48.6 ± 42.6 vs 28.3 ± 30.4, P = .001). Patients with PD with somatization had worst MDS-UPDRS, NMSS, MoCA, and PDQ-8 (all P < .05). CONCLUSION: Somatization is more frequent in persons with PD compared to healthy controls. Somatization in PD is associated with nonmotor symptoms and worst quality of life.
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Atividades Cotidianas , Doença de Parkinson/diagnóstico , Qualidade de Vida/psicologia , Transtornos Somatoformes/psicologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/psicologia , Psicometria , Índice de Gravidade de Doença , Transtornos Somatoformes/diagnóstico , Inquéritos e QuestionáriosRESUMO
A menudo, el acoso laboral ha sido observado como parte de un proceso de violencia al interior de las organizaciones que se internaliza en ellas hasta formar perpetradores y víctimas, pero desde la óptica del clima y la red formativa laboral el presente trabajo se propuso especificar un modelo con la finalidad de estudiar el fenómeno en comento en instituciones de salud pública de alta especialidad y dedicadas a la creación del conocimiento, ya que en éstas prevalecen asimetrías entre investigadores y asistentes, así como por su condición de género o área de especialización. De este modo, se llevó a cabo un estudio no experimental con una selección no probabilística de 218 empleados de una institución de salud pública en el centro de México. A partir de un modelo estructural fue posible apreciar que, ante las consecuencias somáticas del acoso laboral, la intervención de la organización fue determinante para su reducción, aunque el porcentaje de la varianza total explicada sugiere la inclusión de otros factores en el modelo, se recomienda una línea de investigación relativa a la formación de redes institucionales para la prevención o atención inmediata de la problemática(AU)
From an organizational climate and workplace training network perspective, this study proposes a model for the purpose of studying workplace harassment in highly specialized public health institutions dedicated to the generation of knowledge because, in these settings, there are asymmetries between researchers and their staff, as well as by gender and area of expertise. We conducted a non-experimental study in a convenience sample of 218 employees at a public health institution in central Mexico. Based on a structural model, we found that, in the presence of somatic consequences of workplace harassment, organizational interventions were decisive in reducing this form of workplace violence, although the percentage of the total variance explained by the model suggests there are other factors playing a role as well To prevent or immediately respond to workplace harassment, we recommend future research that examines the role of institutional networks in relation to this problem(AU)
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Humanos , Masculino , Feminino , Violência no Trabalho/prevenção & controle , Estresse Ocupacional , Serviços Públicos de Saúde , Instalações de Saúde , Estudos Transversais , Identidade de Gênero , México , Modelos Estruturais , Categorias de TrabalhadoresRESUMO
Objetivou-se verificar em mães de filhos adictos a possibilidade do adoecimento psicossomático quando expostas à vulnerabilidade do envolvimento das drogas. É um estudo qualitativo, de natureza descritiva e exploratória. Como instrumentalização, utilizou-se a Escala de Hamilton, Escala de Alexitimia de Toronto, Inventário de Estratégias de Coping de Folkman e Lazarus, e entrevista semiestruturada. Observou-se traços depressivos, alexítimicos e a presença de adoecimento psicossomático em virtude da exposição à vulnerabilidade envolvendo adicção, assim como os efeitos e consequências da dependência química que afetam diretamente à sociedade, à família, e, sobretudo às mães. Faz-se necessário atribuir importância aos serviços de saúde pública e a necessidade de uma rede de apoio articulada que propicie tratamento especializado para adicto e suporte de enfrentamento para a família.
The aim of this study was to verify the possibility of psychosomatic illness in mothers of addicted children when exposed to the vulnerability of drug involvement. Qualitative study, descriptive and exploratory in nature. The Hamilton Scale, Alexithymia Scale of Toronto, Folkman and Lazarus Coping Strategies Inventory, and semi-structured interview were used as instruments. Depressive, alexithymic traits and the presence of psychosomatic illness were observed due to the exposure to vulnerability involving addiction, as well as the effects and consequences of chemical dependence that directly affect society, the family, and especially the mothers. It is necessary to attach importance to public health services and the need for an articulated support network that provides specialized treatment for addicts and coping support for the family.
Se objetivó verificar en madres de hijos adictos la posibilidad del enfermo psicosomático cuando expuestas a la vulnerabilidad de la implicación de las drogas. Estudio cualitativo, de naturaleza descriptiva y exploratoria. Como instrumentalización se utilizó la Escala de Hamilton, Escala de Alexitimia de Toronto, Inventario de Estrategias de Coping de Folkman y Lazarus, y entrevista semiestructurada. Se observaron rastros depresivos, alexítimicos y la presencia de enfermedad psicosomática en virtud de la exposición a la vulnerabilidad envolviendo adicción, así como los efectos y consecuencias de la dependencia química que afectan directamente a la sociedad, a la familia, y sobre todo a las madres. Se hace necesario atribuir importancia a los servicios de salud pública y la necesidad de una red de apoyo articulada que propicie tratamiento especializado para adicto y soporte de enfrentamiento para la familia.
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Drogas Ilícitas , Doença , Apoio Social , Transtornos Somatoformes , Transtornos Relacionados ao Uso de Substâncias , Serviços de SaúdeRESUMO
BACKGROUND: A study conducted as part of the development of the Eleventh International Classification of Mental Disorders for Primary Health Care (ICD-11 PHC) provided an opportunity to test the relationships among depressive, anxious and somatic symptoms in PHC. METHOD: Primary care physicians participating in the ICD-11 PHC field studies in five countries selected patients who presented with somatic symptoms not explained by known physical pathology by applying a 29-item screening on somatic complaints that were under study for bodily stress disorder. Patients were interviewed using the Clinical Interview Schedule-Revised and assessed using two five-item scales that measure depressive and anxious symptoms. Structural models of anxious-depressive symptoms and somatic complaints were tested using a bi-factor approach. RESULTS: A total of 797 patients completed the study procedures. Two bi-factor models fit the data well: Model 1 had all symptoms loaded on a general factor, along with one of three specific depression, anxiety and somatic factors [x2 (627) = 741.016, p < 0.0011, RMSEA = 0.015, CFI = 0.911, TLI = 0.9]. Model 2 had a general factor and two specific anxious depression and somatic factors [x2 (627) = 663.065, p = 0.1543, RMSEA = 0.008, CFI = 0.954, TLI = 0.948]. CONCLUSIONS: These data along with those of previous studies suggest that depressive, anxious and somatic symptoms are largely different presentations of a common latent phenomenon. This study provides support for the ICD-11 PHC conceptualization of mood disturbance, especially anxious depression, as central among patients who present multiple somatic symptoms.
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Ansiedade/psicologia , Depressão/psicologia , Sintomas Inexplicáveis , Transtornos Mentais/diagnóstico , Adulto , Estudos Transversais , Humanos , Classificação Internacional de Doenças , Internacionalidade , Modelos Lineares , Modelos Logísticos , Atenção Primária à Saúde , Escalas de Graduação Psiquiátrica , Reprodutibilidade dos TestesRESUMO
The aim of this study is at examining the prevalence and impact factors of adolescent somatization tendencies (ST) across three eastern Chinese provinces. A multicenter school-based cross-sectional study was conducted in these provinces from 2015 to 2016. The sample included 11,153 middle-school students aged 13-18 years, who were randomly selected using a multi-phase stratified cluster sampling technique. We also designed a multicenter school-based case-control study to evaluate the potential environmental impact of ST factors on this population. The overall positive rate of ST among the eastern Chinese adolescents was 12.1%. Somatic symptoms score (SSS) and positive ST rate were higher in females than males. Additionally, the SSS and positive ST rate for the 18-year-old group were significantly higher than in other age groups. In comparison to those in urban areas, adolescents in rural areas had significantly higher SSS and positive ST rate. Multiple conditional regression analyses revealed that family medical history, anxiety and depression scores; superstitious beliefs; left-behind adolescents; teacher-student support; family conflict; and family independence and achievement orientation were significantly linked to ST in adolescents. The models also indicated family medical history was the strongest impact factor to adolescent ST, even though ST were prevalent in the three studied eastern Chinese provinces. Gender, age, and dwelling differences were very significant in the SSS and positive ST rate in adolescents. This study concludes that adolescent ST are influenced by multiple environments.
O objetivo deste estudo é examinar a prevalência e fatores de impacto de tendências de somatização (TS) em adolescentes em três províncias do leste da China. Um estudo transversal multicêntrico baseado em escolas foi realizado nessas províncias de 2015 a 2016. A amostra incluiu 11.153 estudantes entre 13 e 18 anos que foram selecionados aleatoriamente usando uma técnica de amostragem estratificada por clusters multi-fase. Também elaboramos um estudo caso-controle multicêntrico baseado em escolas para avaliar o impacto ambiental potencial de fatores de TS nessa população. A taxa positiva geral de TS entre adolescentes do leste chinês foi de 12,1%. O escore de sintomas somáticos (SSS) e taxa positiva de TS foram mais altos entre mulheres do que homens. Adicionalmente, o SSS e taxa positiva de TS para o grupo de 18 anos foram significativamente mais altos do que em outros grupos etários. Em comparação com os habitantes de áreas urbanas, adolescentes de áreas rurais tiveram SSS e taxa positiva de ST significativamente mais altos. Análises de regressão múltipla condicional revelaram que o histórico de saúde da família; scores de ansiedade e depressão; crenças supersticiosas; adolescentes deixados para trás; apoio de professores a estudantes; conflito familiar; e independência familiar e orientação para sucesso estavam significativamente relacionadas a TS em adolescentes. O modelo também indicou que o histórico de saúde da família era o fator de impacto mais forte para TS em adolescentes, ainda que TS sejam prevalentes nas três províncias do leste da China estudadas. Gênero, idade e diferenças residenciais foram muito significativos para o SSS e taxa positiva de TS entre adolescentes. Este estudo conclui que TS entre adolescentes são influenciadas por múltiplos ambientes.
El objetivo de este estudio fue examinar la prevalencia y factores de impacto de las tendencias de somatización adolescentes (TS) en tres provincias orientales chinas. Se realizó un estudio trasversal multicéntrico, basado en escolares de estas provincias de 2015 a 2016. La muestra incluyó a 11.153 estudiantes de secundaria, con edades comprendidas entre los 13-18 años, que fueron seleccionados aleatoriamente, usando a técnicas de muestreo multifase estratificado por conglomerados. También se diseñó un estudio multicéntrico escolar de caso-control para evaluar el potencial impacto ambiental de factores TS en esta población. La tasa positiva general de TS entre adolescentes chinos orientales fue un 12,1%. El marcador de síntomas somáticos (SSS, por sus siglas en inglés) y tasa positiva de TS fueron más altos en mujeres que en hombres. Asimismo, las tasas SSS y TS positiva para el grupo de 18 años de edad fueron significativamente más altas que en otros grupos de edad. En comparación con quienes vivían en áreas urbanas, los adolescentes en áreas rurales contaban con tasas significativamente más altas de SSS y TS positivas. Los análisis de regresión múltiple condicional revelaron que el historial médico familiar, los marcadores de ansiedad y depresión; creencias supersticiosas; adolescentes a la zaga respecto al resto del grupo; el apoyo profesor-estudiante; conflictos familiares; e independencia familiar, así como la orientación de logros estuvieron vinculados a las TS en adolescentes. Los modelos también indicaron que el historial médico familiar fue el impacto más fuerte para las TS en adolescentes, a pesar de que las TS fueron prevalentes en las tres provincias chinas estudiadas. El género, edad, y las diferencias de vivienda fueron muy significativas en la tasas de SSS y TS positivas en adolescentes. Este estudio llega a la conclusión de que las TS adolescentes estaban influenciadas por múltiples entornos.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Transtornos Somatoformes/epidemiologia , Inquéritos e Questionários/estatística & dados numéricos , Meio Ambiente , Ansiedade/psicologia , Ansiedade/epidemiologia , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Transtornos Somatoformes/psicologia , Distribuição Aleatória , Estudos de Casos e Controles , China/epidemiologia , Fatores Sexuais , Saúde da Família/estatística & dados numéricos , Prevalência , Estudos Transversais , Fatores Etários , Depressão/psicologia , Depressão/epidemiologia , Separação da FamíliaRESUMO
Los problemas de salud mental afectan el desarrollo biopsicosocial de las personas. Dichos problemas empeoran debido a que se acude tardíamente a los servicios de salud, evidenciando la necesidad de detecciones tempranas en población abierta. Por ello, el objetivo de esta investigación fue evaluar la relación entre síntomas psicopatológicos y calidad de vida en mujeres y hombres. Participaron 465 personas, habitantes del Estado de México, quienes contestaron el SCL-90-R y el WHOQOL-BREF. En los resultados, las mujeres presentan mayores puntuaciones de síntomas psicopatológicos y menor calidad de vida con respecto a los hombres. Los problemas de salud mental afectan la calidad de vida por diferentes vías de influencia de acuerdo al sexo; en las mujeres destaca la depresión y la sintomatología global; y en los hombres, la somatización, la sintomatología global y la depresión. Se discute sobre la necesidad de prevención y detección precoz de los síntomas incipientes a través del trabajo comunitario.
Mental health problems, which affect biopsychosocial development of people, worsen because people take too long to come to health services. This situation shows the need for early detection of these problems in open populations. Considering this, the present research aimed to assess the relationship between psychopathological symptoms and quality of life in women and men. The study population consisted of 465 inhabitants of the State of Mexico, who answered the SCL-90-R and WHOQOLBREF questionnaires. Results: women have higher scores of psychopathological symptoms and lower quality of life than men. Mental health problems affect quality of life in different ways according to gender: in women, depression and global symptoms stand out; and in men, somatization, global symptoms and depression are the most common ones. This paper discusses the need for prevention and early detection of incipient symptoms of mental health problems through community work.
RESUMO
La presencia de síntomas somáticos en población clínica infantil ha sido analizada en estudios internacionales, pero son escasos los trabajos dirigidos a estudiar las características de los síntomas somáticos en niños españoles con sintomatología depresiva. El presente estudio examina la relación entre las quejas somáticas y los síntomas depresivos en una muestra de niños españoles, teniendo en cuenta su sexo y edad. Participaron 666 niños con edades entre 8 y 12 años que completaron el Inventario de Depresión Infantil y el Inventario de Somatización Infantil que examina 35 síntomas somáticos. Los resultados indican que los síntomas pseudoneurológicos, gastrointestinales y de dolor son más frecuentes en los niños con sintomatología depresiva, siendo el dolor de articulaciones, el dolor de cabeza y el cansancio los síntomas más prevalentes. Se concluye la importancia de atender adecuadamente a los síntomas somáticos puesto que con frecuencia pueden responder a un trastorno emocional más que a una enfermedad física.
The presence of somatic symptoms in children has been widely analyzed in international studies, but there is a lack of studies aimed at studying the characteristics of somatic symptoms in Spanish children with depressive symptoms. This study examines the relationship between somatic complaints and depressive symptoms in a sample of Spanish children, taking into account their age and sex. Participants were 666 children aged between 8 and 12 years who completed the Child Depression Inventory and the Children's Somatization Inventory that examine 35 somatic symptoms. The results indicate that pseudoneurological, pain and gastrointestinal symptoms are more common in children with depressive symptoms, being the joint pain, headache and fatigue the most prevalent symptoms. An adequately detection of somatic symptoms in children could be important due to these symptoms often may respond to an emotional disorder rather than a physical illness.
Assuntos
Humanos , Masculino , Feminino , Criança , Transtornos Psicofisiológicos/psicologia , Transtornos Somatoformes/psicologia , Depressão/psicologia , Espanha , Sintomas InexplicáveisRESUMO
El término somatización está muy extendido en el campo de la clínica psicológica y psiquiátrica. Desde el punto de vista nosográfico la somatización y la conversión se encuentran conceptualizadas en el Manual Diagnóstico y Estadístico de las Enfermedades mentales (DSM-IV-TR) dentro de los Trastornos Somatomorfos. Los trastornos Somatomorfos (TS) agrupan diversos cuadros con una característica en común: la presencia de síntomas somáticos vinculados a un malestar psíquico y deterioro significativo, presentándose frecuentemente en niños y adolescentes. Los síntomas se corresponden con dolencias simples hasta cuadros funcionales invalidantes no explicados por una condición médica general, consumo de sustancias, simulación u otra patología mental. La prevalencia de los TS en la adolescencia ha aumentado en las últimas décadas, representando un desafío clínico y terapéutico para el médico por su dificultad clínica y general desconocimiento (AU)
The term somatization is a broad concept in the field of clinical psychology and psychiatry. From the nosographic point of view, somatization and conversion are conceptualized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IVTR) within the somatoform disorders (SD) characterized by the presence of somatic symptoms associated with psychic pain and significant deterioration, often seen in children and adolescents. The symptoms range from simple discomfort to invalidating functional impairment unexplained by the general medical condition, substance abuse, and simulation or any other mental disorder. Prevalence of SD in adolescence has increased over the past decades, becoming a therapeutic and clinical challenge due to clinical difficulties and lack of unawareness of the disorde (AU)
Assuntos
Humanos , Feminino , Adolescente , Transtorno Conversivo , Equipe de Assistência ao Paciente , Psicologia do Adolescente , Transtornos SomatoformesRESUMO
Este artigo é um estudo teórico da literatura psicanalítica sobre o tema da psicossomática que tem por objetivo revisar os modelos de abordagem desse fenômeno buscando a compreensão de suas diferenças e similitudes em termos de fundamentação teórica. Os resultados apontam para duas maneiras distintas de ver as doenças psicossomáticas, ligadas a duas tradições em psicanálise. Na vertente francesa, ligada mais ou menos diretamente à perspectiva lacaniana, cujas principais referências foram Jacques Alain-Miller e Pierre Marty, o fenômeno não constitui um deslocamento representacional, mas sim uma falha nos processos de simbolização. Em uma segunda vertente, que congrega a Escola Psicossomática de Chicago até autores franceses não lacanianos, cujas principais referências foram Joyce McDougall e Christophe Dejours, o fenômeno psicossomático é compreendido em uma linha divergente, relacionando a formação do sintoma a conflitos inconscientes que são simbolizados na doença, mas em uma forma de simbolização mais precária em relação ao modelo da histeria. Apesar das divergências, entende-se que há conciliação quanto aos princípios na direção do tratamento, que consiste em definir um sentido para o sintoma, não por meio do resgate de uma fantasia inconsciente como no modelo clássico da histeria, e sim construindo um sentido onde não havia encadeamento histórico-narrativo.
This article is a theoretical study of the psychoanalytic literature on the subject of psychosomatic that aims to review the approach models this phenomenon seeking to understand their differences and similarities in terms of theoretical basis. The results point to two different ways of looking at psychosomatic illnesses. In the French side, linked more or less directly to the Lacan perspective, the main references were Jacques-Alain Miller and Pierre Marty, the phenomenon is not a representational shift, but a failure in symbolization processes. In a second aspect, which brings together from the Psychosomatic School of Chicago to French authors not Lacanian, the main references were Joyce McDougall and Christophe Dejours, the psychosomatic phenomenon is understood in a divergent line, relating the formation of the symptom the unconscious conflicts. They are symbolized in the disease, but in a more precarious form of symbolization from the model of hysteria. Despite the differences, it is understood that no compromise on the principles towards the treatment, which is to define a meaning for the symptom, not by the rescue of an unconscious fantasy as in the classic model of hysteria, but building a sense where there was no historical narrative thread.
Este artículo es un estudio teórico de la literatura psicoanalítica sobre el tema de psicosomática que tiene como objetivo revisar los modelos de aproximación a este fenómeno que tratan de comprender sus diferencias y similitudes. Los resultados apuntan a dos formas diferentes: En el lado francés, vinculado más o menos directamente a la perspectiva Lacaniana, las referencias principales fueron Jacques-Alain Miller y Pierre Marty, el fenómeno no es un cambio de representación, pero un fallo en los procesos de simbolización. En un segundo aspecto, que reúne en la Escuela Psicosomática de Chicago a los autores franceses no Lacanianos, las referencias principales fueron Joyce McDougall y Christophe Dejours, el fenómeno psicosomático se entiende en una línea divergente, relativa a la formación del síntoma los conflictos inconscientes Ellos están simbolizadas en la enfermedad, pero en una forma más precaria del modelo de la histeria. A pesar de las diferencias, se entiende que hay compromiso en los principios hacia el tratamiento, que consiste en definir un significado para el síntoma, no por el rescate de una fantasía inconsciente como en el modelo clásico de la histeria, pero la construcción de un sentido en que no había ningún hilo narrativo histórico.
Assuntos
Psicanálise , Transtornos SomatoformesRESUMO
Abstract Background Seborrheic dermatitis is a skin disease in which psychological factors play a central role in its onset, exacerbation and remission. Objective The aim of this study was to investigate personality traits and common psychiatric conditions in patients with SD. Methods Outpatients who were admitted to the Bozok School of Medicine Department of Dermatology complaining of SD and who volunteered for study were included. Symptom Checklist 90 – Revised (SCL-90-R) and Eysenck Personality Questionnaire – Revised Short Form (EPQ-RSF) were administered before treatment to 50 patients who fulfilled the criteria for inclusion in the study. Results compiled from the 50 subjects were compared to a control group that was comprised of 50 healthy volunteers. Results Of the 50 patients that were included in the study, 25 were female and 25 were male. The Global Symptom Index (GSI; Z = -6.96, P < 0.001), Somatization (Z = -6.59, P < 0.001), Depression (Z = -7.11, P < 0.001), and Anxiety (Z = -6.64, P < 0.001) subscales of the SCL-90-R were evaluated. Statistically significantly higher scores were obtained from patients with SD in comparison with the control group on all of these subscales. In addition, the EPQ-RSF Neuroticism subscale was statistically significantly higher (Z = -4.99, P < 0.001) in patients with SD. Discussion Our results showed that common psychiatric conditions are considerably frequent in SD patients. More importantly, neurotic personality characteristics were much more frequent in these patients. These findings suggest SD to be a psychosomatic disorder that requires a multi-disciplinary approach.