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BACKGROUND: Depression in ageing adults is a public health problem. Worldwide studies have identified social and health risk factors for depressive symptoms. However, little is known about their longitudinal determinants in Mexico. OBJECTIVES AND SETTING: To find the prevalence of depressive symptoms and their longitudinal individual and contextual risk factors in Mexican adults aged 50 and older. DESIGN: Secondary data of 6460 persons aged 50 years and older from the Mexican Health and Aging Study were analysed using a 'between-within' panel data analysis approach. RESULTS: The prevalence of depressive symptoms increased from 35% in 2003 to 38% in 2015. The significantly longitudinal factors associated with these symptoms were getting older (OR 1.02, 95% CI 1.01 to 1.03), being a woman (OR 2.39, 95% CI 2.16 to 2.64), less time spent in formal education (0 years and less than 6 years OR 1.52, 95% CI 1.32 to 1.75 and OR 1.33, 95% CI 1.19 to 1.50, respectively), lower net worth (OR 1.13, 95% CI 1.08 to 1.17), being recently unemployed (OR 1.25, 95% CI 1.10 to 1.25), increased (OR 1.17, 95% CI 1.10 to 1.25) or increasing number (OR 1.23, 95% CI 1.15 to 1.31) of chronic conditions, poor (OR 4.68, 95% CI 4.26 to 5.15) or worsened (OR 1.71, 95% CI 1.61 to 1.81) self-rated health and having impairments on instrumental activities of daily living (IADLs) (OR 2.94 95% CI 2.35 to 3.67) or a new IADL impairment (OR 1.67, 95% CI 1.48 to 1.89), as well as having impairments on ADLs (OR 1.51, 95% CI 1.23 to 1.86) or a new ADL impairment (OR 1.34, 95% CI 1.21 to 1.48). CONCLUSIONS: The prevalence of depressive symptoms in Mexican adults aged 50 and older is high. Our findings show that they are longitudinally associated with the individual's demographic, socioeconomic, health and disability characteristics. Efforts in public policy should focus on preventing chronic conditions and disability, as well as fighting inequalities to reduce the prevalence of depressive symptoms.
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Depressão , Humanos , México/epidemiologia , Feminino , Masculino , Estudos Longitudinais , Pessoa de Meia-Idade , Idoso , Depressão/epidemiologia , Fatores de Risco , Prevalência , Fatores Socioeconômicos , Idoso de 80 Anos ou mais , Envelhecimento/psicologia , Atividades CotidianasRESUMO
OBJECTIVES: The study evaluated the association of academic environment, lifestyle, sense of coherence (SOC) and social support with self-reported mental health status among dental students. DESIGN: Secondary analysis of data from a cross-sectional, questionnaire-based survey conducted from August to October 2018. SETTING: Dental school of a public-funded university in the south-eastern region of Brazil. PARTICIPANTS: 233 undergraduate dental students recruited across all years of the course. OUTCOME MEASURES: Socioeconomic and demographic characteristics, city of origin and student's academic semester were obtained through self-completed questionnaires. Perception of the academic environment (Dundee Ready Education Environment Measure (DREEM)), individual lifestyle (Individual Lifestyle Profile Questionnaire (ILPQ)), SOC (SOC Scale (SOC-13)), social support (Medical Outcomes Study Scale (MOS)), and depression, anxiety and stress (Depression, Anxiety and Stress Scale-21 (DASS-21)) were assessed using validated instruments. The relationships between variables were investigated through multivariable negative binomial regression to obtain the rate ratios (RRs) and 95% CIs. RESULTS: Female sex was associated with greater scores of anxiety (RR 1.74, 95% CI 1.10 to 1.97) and stress (RR 1.52, 95% CI 1.12 to 2.06). Students who perceived a better academic environment and those reporting a greater SOC had a lower probability of depression, anxiety and stress. Furthermore, a favourable lifestyle was associated with lower depression scores (RR 0.99, 95% CI 0.97 to 0.99). Social support did not remain associated with depression, anxiety and stress after adjustment. CONCLUSIONS: The present findings suggest that self-reported mental health status is associated with students' sex, academic environment, SOC and lifestyle. Enhancing the educational environment and SOC, and promoting a healthy lifestyle may improve the psychological health of dental students.
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Senso de Coerência , Estudantes de Medicina , Humanos , Feminino , Estudos Transversais , Autorrelato , Estudantes de Odontologia/psicologia , Universidades , Brasil/epidemiologia , Estilo de Vida , Apoio Social , Inquéritos e Questionários , Nível de Saúde , Estudantes de Medicina/psicologiaRESUMO
OBJECTIVES: The Patient Health Questionnaire (PHQ) and Generalised Anxiety Disorder Scale (GAD) are widely used screening tools, but their sensitivity and specificity in low-income and middle-income countries are lower than in high-income countries. We conducted a study to determine the sensitivity and specificity of different versions of these scales in a Peruvian hospital population. DESIGN: Our study has a cross-sectional design. SETTING: Our participants are hospitalised patients in a Peruvian hospital. The gold standard was a clinical psychiatric interview following ICD-10 criteria for depression (F32.0, F32.1, F32.2 and F32.3) and anxiety (F41.0 and F41.1). PARTICIPANTS: The sample included 1347 participants. A total of 334 participants (24.8%) were diagnosed with depression, and 28 participants (2.1%) were diagnosed with anxiety. RESULTS: The PHQ-9's≥7 cut-off point showed the highest simultaneous sensitivity and specificity when contrasted against a psychiatric diagnosis of depression. For a similar contrast against the gold standard, the other optimal cut-off points were: ≥7 for the PHQ-8 and ≥2 for the PHQ-2. In particular, the cut-off point ≥8 had good performance for GAD-7 with sensitivity and specificity, and cut-off point ≥10 had lower levels of sensitivity, but higher levels of specificity, compared with the cut-off point of ≥8. Also, we present the sensitivity and specificity values of each cut-off point in PHQ-9, PHQ-8, PHQ-2, GAD-7 and GAD-2. We confirmed the adequacy of a one-dimensional model for the PHQ-9, PHQ-8 and GAD-7, while all PHQ and GAD scales showed good reliability. CONCLUSIONS: The PHQ and GAD have adequate measurement properties in their different versions. We present specific cut-offs for each version.
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Depressão , Questionário de Saúde do Paciente , Humanos , Estudos Transversais , Depressão/diagnóstico , Peru , Reprodutibilidade dos Testes , Ansiedade/diagnóstico , HospitaisRESUMO
OBJECTIVE: The objective of this study was to identify trajectories of depressive symptoms (DSs) during the first half of drug-sensitive pulmonary tuberculosis (PTB) treatment and examine their association with loss to follow-up (LTFU) in the second half. DESIGN: This study involved a secondary analysis of longitudinal data to identify potential trajectories of DS and their relationship with LTFU. SETTING: The study was conducted in first and second-level health centres located in San Juan de Lurigancho, Lima, Peru. PARTICIPANTS: Anonymised data from 265 individuals, including monthly measures of DSs from diagnosis to the completion of treatment, initiation of treatment for multidrug resistant TB, LTFU or death, were collected. RESULTS: Three trajectories were identified: 'declining', 'growth' and 'high'. These trajectories were observed in 182 (68.7%), 53 (20%) and 30 (11.3%) of the 265 individuals, respectively, during the first half of PTB treatment. Compared with those with a 'declining' trajectory, individuals with a 'growth' trajectory had a higher likelihood of experiencing LTFU during the second half of PTB treatment, after controlling for sociodemographic factors and at least weekly alcohol use (OR 3.9; 95% CI 1.09 to 13.97, p=0.036). CONCLUSIONS: The findings suggest that a trajectory of increasing DSs during the first half of PTB treatment is associated with a higher risk of LTFU during the second half.
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Depressão , Tuberculose Pulmonar , Humanos , Seguimentos , Depressão/tratamento farmacológico , Depressão/epidemiologia , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/epidemiologia , Probabilidade , Peru/epidemiologia , Fatores de RiscoRESUMO
OBJECTIVE: The objective of this study was to assess the quality of clinical practice guidelines (CPGs) for the pharmacological treatment of depression along with their recommendations and factors associated with higher quality. DESIGN: We conducted a systematic review that included CPGs for the pharmacological treatment of depression in adults. DATA SOURCES: We searched for publications from 1 January 2011 to 31 December 2021, in MEDLINE, Cochrane Library, Embase, PsycINFO, BVS and 12 other databases and guideline repositories. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included CPGs containing recommendations for the pharmacological treatment of depression in adults at outpatient care setting, regardless of whether it met the U.S. National Academy of Medicine criteria, or not. If a CPG included recommendations for both children and adults, they were considered. No language restriction was applied. DATA EXTRACTION AND SYNTHESIS: Data extraction was also conducted independently and in duplicate, a process that was validated in a previous project. The quality of the CPGs and their recommendations were assessed by three independent reviewers using Appraisal of Guidelines for Research and Evaluation (AGREE II) and Appraisal of Guidelines for Research and Evaluation-Recommendations Excellence (AGREE-REX). A CPG was considered to be of high quality if AGREE II Domain 3 was ≥60%; while their recommendations were considered high if AGREE-REX Domain 1 was ≥60%. RESULTS: Seventeen out of 63 (27%) CPGs were classified as high quality, while 7 (11.1%) had high-quality recommendations. The factors associated with higher-scoring CPGs and recommendations in the multiple linear regression analyses were 'Handling of conflicts of interest', 'Multiprofessional team' and 'Type of institution'. 'Inclusion of patient representative in the team' was also associated with higher-quality recommendations. CONCLUSIONS: The involvement of professionals from diverse backgrounds, the handling of conflicts of interest, and the inclusion of patients' perspectives should be prioritised by developers aiming for high-quality CPGs for the treatment of depression.
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Depressão , Medicina , Criança , Adulto , Humanos , Depressão/tratamento farmacológico , Bases de Dados Factuais , Instalações de SaúdeRESUMO
OBJECTIVES: To assess the prevalence of and factors associated with the lifetime medical diagnosis of depression in Brazil. DESIGN: Population-based, cross-sectional study. SETTING: Analysis of data from the 2019 Brazilian National Health Survey. PARTICIPANTS: 90 846 individuals aged ≥15 years were included. OUTCOME MEASURE: The self-reported medical diagnosis of depression at some point in one's life was the main outcome. Prevalence ratios (PRs) with 95% CIs were calculated by Poisson regression with robust variance. The independent variables included the geographical area of residence, sociodemographic characteristics, current smoking status, alcohol abuse, daily screen time, and the presence of physical disorders and mental health comorbidities. RESULTS: The self-reported lifetime prevalence of medical diagnosis of depression was 9.9% (95% CI 9.5% to 10.2%). The probability of having received a medical diagnosis of depression was higher among urban residents (PR 1.23; 95% CI 1.12 to 1.35); females (2.75; 2.52 to 2.99); those aged 20-29 years (1.17; 0.91 to 1.51), 30-39 years (1.73; 1.36 to 2.19), 40-49 years (2.30; 1.81 to 2.91), 50-59 years (2.32; 1.84 to 2.93) and 60-69 years (2.27; 1.78 to 2.90) compared with those under 20 years; white-skinned people (0.69 (0.61 to 0.78) for black-skinned people and 0.74 (0.69 to 0.80) for indigenous, yellow and brown-skinned people compared with white-skinned people); those with fewer years of education (1.33(1.12 to 1.58) among those with 9-11 years, 1.14 (0.96 to 1.34) among those with 1-8 years and 1.29 (1.11 to 1.50) among those with 0 years compared with those with ≥12 years of education); those who were separated/divorced (1.43; 1.29 to 1.59), widowed (1.06; 0.95 to 1.19) and single (1.01; 0.93 to 1.10) compared with married people; smokers (1.26; 1.14 to 1.38); heavy screen users (1.31; 1.16 to 1.48) compared with those whose usage was <6 hours/day; those with a medical diagnosis of a physical disorder (1.80; 1.67 to 1.97); and individuals with a medical diagnosis of a mental health comorbidity (5.05; 4.68 to 5.46). CONCLUSION: This nationwide population-based study of self-reported lifetime medical diagnosis of depression in Brazil showed that the prevalence was almost 10%. Considering the current Brazilian population, this prevalence corresponds to more than 2 million people who have been diagnosed with depression at some point in their lives.
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Depressão , Feminino , Humanos , Autorrelato , Depressão/diagnóstico , Depressão/epidemiologia , Brasil/epidemiologia , Prevalência , Estudos Transversais , Inquéritos EpidemiológicosRESUMO
INTRODUCTION: Mental healthcare systems are challenged by how they hear and respond to what marginalised communities experience as drivers of mental distress. In Colombia, this challenge intersects with wider challenges facing post-conflict reconstruction. Our pilot study will explore the feasibility and acceptability of a participatory approach to developing community-led participatory interventions for community mental health systems strengthening and mental health improvement, in two sites in Caquetá, Colombia. METHODS AND ANALYSIS: The project is divided into three distinct phases aligned with community participatory action research cycles: diagnostic, intervention and evaluation. This allows us to use a participatory approach to design a community-led, bottom-up intervention for mental health systems strengthening and the promotion of mental health and well-being.The diagnostic phase explores local understandings of mental health, mental distress and access to mental health services from community members and health providers. The intervention stage will be guided by a participatory Theory of Change process. Community priorities will inform the development of a participatory, learning and action (PLA) informed group intervention, with a community linkage forum. The pilot of the PLA intervention will be evaluated using MRC process evaluation guidelines. ETHICS AND DISSEMINATION: This project has received ethical approval from two sources. Universidad de Los Andes (2021-1393) and the University College London (16127/005). Dissemination of findings will include academic publications, community forums, policy briefs and visual media (cartoons, pod casts and short films).
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Serviços Comunitários de Saúde Mental , Humanos , Projetos Piloto , Colômbia , Projetos de Pesquisa , Pesquisa sobre Serviços de Saúde , PoliésteresRESUMO
OBJECTIVE: To evaluate the relationship between job satisfaction, burnout syndrome (BS) and depressive symptoms (DS) based on the job demand-control framework model on a nationally representative sample of physicians working in the Peruvian Health System. SETTING: We carried out a secondary data analysis of the National Survey of Satisfaction of Users in Health 2016 in Peru. PRIMARY AND SECONDARY OUTCOME MEASURES: Our study assessed the development of the predictive model and had two parts: (1) to evaluate the association among the variables based on the job demand-control framework, and (2) to assess the proposed model acceptability using the structural equation modelling approach to estimate goodness-of-fit indices (GOFIs). PARTICIPANTS: We excluded physicians older than 65 years, who did not report income levels or who had missing data related to the workplace. Thus, we analysed 2100 participants. RESULTS: The prevalence of DS was 3.3%. Physicians' work-related illnesses had more probability to result in DS (prevalence ratio=2.23). DS was moderately related to BS dimensions (r>0.50); nevertheless, the relationships between DS and the three job satisfaction scales were weak (r<0.30). The first predictive model based on the variables, DS, BS and job satisfaction, had low GOFIs (comparative fit index (CFI)=0.883; root mean square error of approximation (RMSEA)=0.125). In a second evaluation, we used models with correlated errors obtaining optimal GOFIs (CFI=0.974; RMSEA=0.060). CONCLUSIONS: Our study identified a stable model to explain the relationship between job satisfaction, BS and DS among physicians. The results are consistent with the job demand-control framework. They could be applied to decision-making in occupational contexts in Latin American low/middle-income countries.
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Esgotamento Profissional , Satisfação no Emprego , Humanos , Estudos Transversais , Esgotamento Profissional/epidemiologia , Análise de Classes Latentes , Depressão/epidemiologia , Local de Trabalho , Esgotamento PsicológicoRESUMO
OBJECTIVE: To explore which resources and activities help young people living in deprived urban environments in Latin America to recover from depression and/or anxiety. DESIGN: A multimethod, qualitative study with 18 online focus groups and 12 online structured group conversations embedded into arts workshops. SETTING: This study was conducted in Bogotá (Colombia), Buenos Aires (Argentina) and Lima (Peru). PARTICIPANTS: Adolescents (15-16 years old) and young adults (20-24 years old) with capacity to provide assent/consent and professionals (older than 18 years of age) that had experience of professionally working with young people were willing to share personal experience within a group, and had capacity to provide consent. RESULTS: A total of 185 participants took part in this study: 111 participants (36 adolescents, 35 young adults and 40 professionals) attended the 18 focus groups and 74 young people (29 adolescents and 45 young adults) took part in the 12 arts workshops. Eight categories captured the resources and activities that were reported by young people as helpful to overcome mental distress: (1) personal resources, (2) personal development, (3) spirituality and religion, (4) social resources, (5) social media, (6) community resources, (7) activities (subcategorised into artistic, leisure, sports and outdoor activities) and (8) mental health professionals. Personal and social resources as well as artistic activities and sports were the most common resources identified that help adolescents and young adults to overcome depression and anxiety. CONCLUSION: Despite the different contexts of the three cities, young people appear to use similar resources to overcome mental distress. Policies to improve the mental health of young people in deprived urban settings should address the need of community spaces, where young people can play sports, meet and engage in groups, and support community organisations that can enable and facilitate a range of social activities.
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Saúde Mental , Adolescente , Adulto , Cidades , Humanos , América Latina , Peru , Pesquisa Qualitativa , Adulto JovemRESUMO
OBJECTIVE: To assess similarities and differences in the recommended sequence of strategies among the most relevant clinical practice guidelines (CPGs) for the treatment of depression in adults with inadequate response to first-line treatment. DATA SOURCES: We performed a systematic review of the literature spanning January 2011 to August 2020 in Medline, Embase, Cochrane Library and 12 databases recognised as CPGs repositories. CPGs quality was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). STUDY SELECTION: The eligibility criteria were CPGs that described pharmacological recommendations for treating depression for individuals aged 18 years or older in outpatient care setting. We included CPGs considered of high-quality (≥80% in domain 3 of AGREE II) or recognised as clinically relevant. DATA EXTRACTION: Two independent researchers extracted recommendations for patients who did not respond to first-line pharmacological treatment from the selected CPGs. RESULTS: We included 46 CPGs and selected 8, of which 5 were considered high quality (≥80% in domain 3 of AGREE II) and 3 were recognised as clinically relevant. Three CPGs did not define inadequate response to treatment and 3 did not establish a clear sequence of strategies. The duration of treatment needed to determine that a patient had not responded was not explicit in 3 CPGs and was discordant in 5 CPGs. Most CPGs agree in reassessing the diagnosis, assessing the presence of comorbidities, adherence to treatment, and increase dosage as first steps. All CPGs recommend psychotherapy, switching antidepressants, and considering augmentation/combining antidepressants. CONCLUSION: Relevant CPGs present shortcomings in recommendations for non-responders to first-line antidepressant treatment including absence and divergencies in definition of inadequate response and sequence of recommended strategies. Overall, most relevant CPGs recommend reassessing the diagnosis, evaluate comorbidities, adherence to treatment, increase dosage of antidepressants, and psychotherapy as first steps. PROSPERO REGISTRATION NUMBER: CRD42016043364.
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Lista de Checagem , Depressão , Adolescente , Adulto , Antidepressivos/uso terapêutico , Depressão/diagnóstico , Depressão/tratamento farmacológico , HumanosRESUMO
OBJECTIVES: To assess the prevalence of burnout syndrome among intensive care physicians working in a tertiary private hospital as well as their perceived impact of the COVID-19 pandemic on their life. DESIGN: A cross-sectional study. SETTING: Intensive care units dedicated to the care of COVID-19 in Hospital Sirio-Libanes, Sao Paulo, Southeastern part of Brazil. PARTICIPANTS: Intensive care physicians. INTERVENTIONS: Each participant received an envelope with a questionnaire composed of demographic and occupational variables, information related to their personal and professional experiences facing the COVID-19 pandemic and the Maslach Burnout Inventory questionnaire. PRIMARY AND SECONDARY OUTCOMES MEASURES: The primary outcome was to assess the prevalence of burnout syndrome among physicians working in an intensive care unit dedicated to the care of COVID-19. RESULTS: A total of 51 from the universe of 63 (82%) intensive care physicians participated in the study. Nineteen (37.2%) met the criteria for burnout syndrome. In the three domains that characterise burnout syndrome, we found a low level of personal achievement in 96.1% of physicians interviewed, a high level of depersonalisation in 51.0% and 51.0% with a high level of emotional exhaustion. Decision-making conflicts between the intensive care unit team and other attending physicians were frequent (50% of all conflicts). A third of the participants had been diagnosed with COVID-19, 22 (43.1%) reported having a family member infected and 8 (15.7%) lost someone close to the COVID-19 pandemic. Participants felt that fear of infecting their loved ones was the aspect of their lives that changed most as compared with the prepandemic period. CONCLUSIONS: Burnout syndrome was frequent among intensive care unit physicians treating patients with COVID-19 in a large tertiary private hospital. Future studies should expand our results to other private and public hospitals and test strategies to promote intensive care unit physicians' mental health.
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Esgotamento Profissional , COVID-19 , Médicos , Brasil/epidemiologia , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Esgotamento Psicológico/epidemiologia , COVID-19/epidemiologia , Cuidados Críticos , Estudos Transversais , Humanos , Pandemias , Médicos/psicologia , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Adolescent suicide is a worldwide public health problem, being the second and the third leading cause of death in the 15-29 and the 15-19 age groups, respectively. Among adolescents, it is estimated that for every suicide, there are 100-200 suicide attempts. Although 79% of suicides in the world occur in low/middle-income countries, most of scientific evidence comes from high-income and low-risk countries. In recent years, adolescent suicide rates have steadily increased in Chile. Deaths caused by self-harm increased by 220% in the population aged 10-19 years between 2000 and 2015. The Maule Region is one of the regions of Chile with the highest levels of suicide among those aged 15 and 19 years old. The objective of this study is to evaluate the trajectories of ideation and suicidal attempts in adolescents with psychiatric disorders treated within the public health system of the Maule Region, Chile, based on different clinical, psychological and neuropsychological factors. METHOD: A prospective naturalistic study of a clinical sample of adolescents under psychiatric treatment in the Maule Region, Chile. Adolescents will be evaluated using a thorough protocol that includes suicide-related clinical variables. The study seeks to establish patterns of change in the trajectories of ideation and suicide attempts among adolescents. ETHICS AND DISSEMINATION: Ethical approval was granted by the Scientific Ethics Committee of the Universidad Católica del Maule in Chile. This protocol was registered in ClinicalTrials.gov. The results of this study will be disseminated to health centres through executive reports and feedback sessions. In addition, the most relevant findings will be presented in scientific articles, conferences and seminars open to the community. TRIAL REGISTRATION NUMBER: NCT04635163.
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Transtornos Mentais , Ideação Suicida , Adolescente , Criança , Chile/epidemiologia , Humanos , Transtornos Mentais/epidemiologia , Estudos Prospectivos , Fatores de Risco , Tentativa de Suicídio/psicologia , Adulto JovemRESUMO
INTRODUCTION: Emerging adulthood is a period of instability with changes in personal relationships and often a series of job changes before life trajectories clarify and more lasting decisions are possible. These changes often produce distress, and they might explain why most of the symptoms that impact the individual's mental health throughout their lives appear at this stage, although full-blown disorders are often only diagnosed subsequently. The objective of this study is to analyse the intraindividual changes in psychological distress and health-related quality of life in both student and non-student emerging adults over 1 year. Between-individual differences in variability will be analysed and life events will be recorded to identify possible associations. METHODS AND ANALYSIS: Participants will be emerging adults (18-29 years of age) students and non-students. The primary outcome will be psychological distress measured using the Clinical Outcomes in Routine Evaluation-Outcome Measure and the secondary outcome will be health-related quality of life measured by the EuroQol five-dimension-three-level. Sociodemographic and life events will be recorded. Information will be collected using an online survey.Analyses, described in a data analysis plan with the registration, will check the psychometric properties of the measures, describe the distribution of scores on the outcome measures, their relationship to group and other demographic variables and how they change over the seven assessment points across a year and explore any relationship between scores and life events. ETHICS AND DISSEMINATION: This study received ethical approval by the Comité de Ética y Bioética (Ethics and Bioethics Committee) of the Universidad de Las Américas, Quito-Ecuador (2020-0807). Results will be published in peer-reviewed journals and presented at relevant meetings. Brief reports of these publications will be disseminated using social media to reach the community and private or public organisations interested in emerging adults. TRIAL REGISTRATION NUMBER: NCT04596345.
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Angústia Psicológica , Qualidade de Vida , Adulto , Estudos de Coortes , Equador/epidemiologia , Humanos , Saúde Mental , Estudos Observacionais como Assunto , Qualidade de Vida/psicologiaRESUMO
INTRODUCTION: Faced with the continuous growth in the number of older people at a global level, some concerns are raised about the way people age. Health conditions such as depressive symptoms and depression have a direct or indirect impact on the quality of life of this population segment. The objective of this study is to verify the incidence of the various presentations of the depressive spectrum in the community-dwelling older population, as well as to analyse the predictive factors. METHODS AND ANALYSIS: This systematic review and meta-analysis protocol follows the recommendation of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Searches will be conducted in PubMed, Web of Science, Scopus, Latin-American and Caribbean Literature on Health Sciences, Scientific Electronic Library Online and Cochrane databases, as well as grey literature. The search strategy involves terms related to ageing and the depressive spectrum found in observational studies. There will be no language restriction and the material included will be the ones whose publications took place until December 2020. ETHICS AND DISSEMINATION: Formal ethical approval is not required on this research, since it only aims secondary data. After publishing the results in a scientifically supported journal, our findings may be disseminated to fill in the gaps and guide the production of more effective public policies directed at a more adequate care to the older population at a global level. The search process began in January 2021 and it is expected that all stages of the review will be completed by 30 November 2021. PROSPERO REGISTRATION NUMBER: CRD42019121616.
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Depressão , Vida Independente , Idoso , Região do Caribe , Depressão/epidemiologia , Humanos , Incidência , Metanálise como Assunto , Qualidade de Vida , Projetos de Pesquisa , Revisões Sistemáticas como AssuntoRESUMO
OBJECTIVE: To provide evidence on the effect of the COVID-19 pandemic on the mental health of young people who grew up in poverty in low/middle-income countries (LMICs). DESIGN: A phone survey administered between August and October 2020 to participants of a population-based longitudinal cohort study established in 2002 comprising two cohorts born in 1994-1995 and 2001-2002 in Ethiopia, India (Andhra Pradesh and Telangana), Peru and Vietnam. We use logistic regressions to examine associations between mental health and pandemic-related stressors, structural factors (gender, age), and lifelong protective/risk factors (parent and peer relationship, wealth, long-term health problems, past emotional problems, subjective well-being) measured at younger ages. SETTING: A geographically diverse, poverty-focused sample, also reaching those without mobile phones or internet access. PARTICIPANTS: 10 496 individuals were approached; 9730 participated. Overall, 8988 individuals were included in this study; 4610 (51%) men and 4378 (49%) women. Non-inclusion was due to non-location or missing data. MAIN OUTCOME MEASURES: Symptoms consistent with at least mild anxiety or depression were measured by Generalized Anxiety Disorder-7 (≥5) or Patient Health Questionnaire-8 (≥5). RESULTS: Rates of symptoms of at least mild anxiety (depression) were highest in Peru at 41% (32%) (95% CI 38.63% to 43.12%; (29.49-33.74)), and lowest in Vietnam at 9% (9%) (95% CI 8.16% to 10.58%; (8.33-10.77)), mirroring COVID-19 mortality rates. Women were most affected in all countries except Ethiopia. Pandemic-related stressors such as health risks/expenses, economic adversity, food insecurity, and educational or employment disruption were risk factors for anxiety and depression, though showed varying levels of importance across countries. Prior parent/peer relationships were protective factors, while long-term health or emotional problems were risk factors. CONCLUSION: Pandemic-related health, economic and social stress present significant risks to the mental health of young people in LMICs where mental health support is limited, but urgently needed to prevent long-term consequences.
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Ansiedade/epidemiologia , COVID-19/psicologia , Depressão/epidemiologia , Pandemias , Adulto , Etiópia/epidemiologia , Feminino , Humanos , Índia/epidemiologia , Estudos Longitudinais , Masculino , Saúde Mental , Peru/epidemiologia , Vietnã/epidemiologia , Adulto JovemRESUMO
INTRODUCTION: Among patients with cancer, depression is still under-detected. The use of technology-assisted screening tools is rising; however, little is known about the uptake of these devices as depression screening tools among patients with cancer. METHODS AND ANALYSIS: A systematic review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). The review is registered with PROSPERO and any adjustments to the protocol will be traced. The aims of this systematic review are to (1) identify the most common and feasible depression screening information technology (IT) delivery models among patients with cancer, (2) identify the most common depression screening instrument used in IT devices and (3) describe the published technology-assisted depression screening tools for patients with cancer. PubMed, EBSCOhost and Google Scholar databases will be used. PICO (Patient/Population, Intervention, Comparison, Outcomes) guidelines will inform the inclusion criteria. Two researchers will independently review titles and abstracts, followed by full article review and data extraction. In the case of a disagreement, a third reviewer will make the final decision. Title/abstract screening will be conducted using a screening tool prepared by the researchers. Articles will be included for review if: (1) the study includes patients with cancer, cancer survivors and/or patients on remission, (2) depression is screened using technology and (3) technology-assisted depression screening effectiveness, efficacy, feasibility and/or acceptance is addressed. The quality of the articles will be assessed using the Methodological Index For Non-Randomised Studies (MINORS, maximum score 24) through independent coding of reviewers. ETHICS AND DISSEMINATION: This research is exempt from ethics approval given that this is a protocol for a systematic review, which uses published data. Findings from this review will be disseminated through peer-reviewed publications and scientific conferences. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42019121048.
Assuntos
Depressão , Neoplasias , Depressão/diagnóstico , Detecção Precoce de Câncer , Humanos , Programas de Rastreamento , Metanálise como Assunto , Neoplasias/complicações , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , TecnologiaRESUMO
OBJECTIVES: This study aimed to estimate the trends in the prevalence and treatment of depressive symptoms using nationally representative surveys in Peru from 2014 to 2018. DESIGN: A secondary analysis was conducted using five nationally representative surveys carried out consecutively in the years between 2014 and 2018. SETTING: The study was conducted in Peru. PARTICIPANTS: Individuals, men and women, aged ≥15 years who participated in the selected surveys. Sampling was probabilistic using a two-stage approach. MAIN OUTCOME MEASURES: Two versions of the Patient Health Questionnaire (PHQ-9) that focused on the presence of depressive symptoms were administered (one in the last 2 weeks and other in the last year). Scores ≥15 were used as the cut-off point in both versions of the PHQ-9 to define the presence of depressive symptoms. Also, the treatment rate was based on the proportion of individuals who had experienced depressive symptoms in the last year and who had self-reported having received specific treatment for these symptoms. The age-standardised prevalence was estimated. RESULTS: A total of 161 061 participants were included. There was no evidence of a change in age-standardised prevalence rates of depressive symptoms at the 2 weeks prior to the point of data collection (2.6% in 2014 to 2.3% in 2018), or in the last year (6.3% in 2014 to 6.2% in 2018). Furthermore, no change was found in the proportion of depressive cases treated in the last year (14.6% in 2014 to 14.4% in 2018). Rural areas and individuals with low-level of wealth had lower proportion of depressive cases treated. CONCLUSIONS: No changes in trends of rates of depressive symptoms or in the proportion of depressive cases treated were observed. This suggests the need to reduce the treatment gap considering social determinants associated with inequality in access to adequate therapy.