G��nero, sa��de funcional subjectiva e depressão em adultos idosos: Teste de um modelo estrutural

Disserta����o de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obten����o de grau de Mestre na especialidade de Psicologia Cl��nica.

IVG: Um indutor de altera����es psicol��gicas? Estudo dos n��veis de depressão, ansiedade e stress em mulheres no pr�� e p��s I.V.G.

Disserta����o de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obten����o de grau de Mestre na especialidade de Psicologia Cl��nica.

Reabilita����o psicossocial do doente com depressão

A evid��ncia demonstra que as patologias do humor ocupam um lugar de destaque no panorama nacional. Elas s��o objeto de aten����o dos enfermeiros e imp��emse como um compromisso para a forma����o pessoal e profissional. Procurei ent��o desenvolver compet��ncias cl��nicas de avalia����o diagn��stica e de interven����o em contexto de cuidados, no dom��nio da sa��de mental e psiquiatria. E apresentar sob a forma de relat��rio de est��gio todo este processo. Dotado de um conjunto de conhecimentos pr��vios desenvolvi com os doentes estrat��gias de interven����o. Estas foram definidas a partir de uma avalia����o diagn��stica que sistematicamente foi reformulada em fun����o dos resultados que iam sendo obtidos com as respetivas interven����es. Os resultados demonstram que esta interven����o permitiu aos doentes mudar a forma como se veem, aumentar a sua capacidade de afirma����o, expressar os seus sentimentos e pensamentos e, estabelecer a autoconfian��a no sentido de facilitar o processo de reintegra����o familiar e social; ABSTRACT: PSYCHOSOCIAL REHABILITATION OF THE PATIENT WITH DEPRESSION Evidence shows that the pathologies humour occupy a prominent place on the national scene. They are nurses object of attention and impose themselves as a commitment to personal and professional development. I looked then develop clinical skills diagnostic assessment and intervention in the context of care in the field of mental health and psychiatry. And in the form of internship report this whole process. With a set of previous knowledge developed with patients intervention strategies. These were defined from a diagnostic evaluation that has been systematically reformulated depending on the results that were being achieved with the respective intervention. The results show that this intervention allowed the patients change the way they come, increase their assertiveness, express their feelings and thoughts and establish the confidence to facilitate the process of family and social reintegration.

Curar a pr��pria hist��ria : uma an��lise sociol��gica da terap��utica da depressão

Tese (doutorado)���Universidade de Bras��lia, Instituto de Ci��ncias Sociais, Departamento de Sociologia, 2015.

Depressão na Adolesc��ncia: Um Estudo de Caso

Disserta����o de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obten����o de grau de Mestre na especialidade de Psicologia Cl��nica.

Isolamento social e indicadores de depressão em adolescentes: Um estudo longitudinal

Tese submetida como requisito parcial para a obten����o do grau de Mestre em Psicologia Aplicada Especialidade em Psicologia Cl��nica

Ades��o ao tratamento em pacientes com depressão major: A influ��ncia da percep����o de doen��a, suporte social, espiritualidade e do estado emocional

Este estudo teve como finalidade investigar a rela����o entre alguns factores psicossociais e a ades��o terap��utica, utilizando como vari��veis preditoras, as representa����es de doen��a, a ansiedade e depressão as previs��es de suporte social, e a espiritualidade e como vari��veis de resultado, a ades��o ao regime terap��utico, atrav��s da avalia����o da ades��o �� medica����o. Pretendeu-se testar quatro hip��teses: (1) Prev��-se que as representa����es de depressão nas suas dimens��es da consequ��ncias, dura����o e controlo pessoal e de tratamento, identidade, preocupa����o, emo����es e compreens��o da doen��a sejam preditores significativos da ades��o ao tratamento medicamentoso; (2) Prev��-se que os n��veis de ansiedade e depressão dos doentes depressivos estar��o significativa e negativamente correlacionados com os n��veis de ades��o ao tratamento medicamentoso; (3) Prev��-se que os n��veis de suporte social percebido estar��o significativa e positivamente correlacionados com os n��veis de ades��o ao tratamento medicamentoso e (4) Prev��-se que os n��veis de espiritualidade se encontrem significativa e positivamente correlacionados com os n��veis de ades��o ao tratamento medicamentoso. Tratou-se de um estudo transversal, com desenho correlacionai e foi desenvolvido num Hospital da Regi��o do Alentejo, mais especificamente, num Departamento de Psiquiatria a sa��de Mental, com uma amostra n��o aleat��ria de 15 pacientes com o diagn��stico de Depressão. Os resultados confirmaram parcialmente a primeira hip��tese, sendo as representa����es de doen��a, nas suas dimens��es controlo pessoal, controlo do tratamento e emo����es preditores significativos da ades��o (mais especificamente das altera����es das doses da medica����o). A segunda hip��tese tamb��m foi confirmada parcialmente, sendo a depressão preditora da ades��o (tanto na dimens��o do esquecimento, quanto na altera����o das doses da medica����o). A terceira hip��tese foi, tamb��m, parcialmente confirmada sendo a alian��a fi��vel preditora significativa da ades��o (na dimens��o do esquecimento da toma da medica����o). Por ��ltimo, a quarta hip��tese foi igualmente confirmada parcialmente sendo a esperan��a/optimismo preditora significativa da ades��o (tanto na dimens��o do esquecimento, quanto na altera����o das doses da medica����o). Nas an��lises explorat��rias verificou-se a influ��ncia da vari��vel s��cio�� demogr��fico ���sexo��� nas representa����es cognitivas e tamb��m na depressão. A "idade" tamb��m demonstrou algum efeito nas altera����es �� medica����o e nas provis��es sociais. O "estado civil" mostrou efeito no aconselhamento e na oportunidade de presta����o de valores. As vari��veis cl��nicas tamb��m mostraram ter influ��ncia. O "tempo de doen��a" mostrou efeito significativo nas representa����es emocionais, nas cren��as, esperan��a/optimismo e no esquecimento da medica����o. A "dura����o do tratamento com medica����o" mostrou efeito na compreens��o da doen��a e no esquecimento da medica����o. Por fim, s��o apresentadas algumas implica����es da depressão, bem como algumas sugest��es para estudos futuros. /ABSTRACT: This study aimed to investigate the relationship between some psychosocial factors and the adherence, using as predictor variables, the representations of illness, the anxiety and depression, the social support predictions, and spirituality, and as outcome variables, adherence to treatment regimen, through the assessment of medication adherence. lt was intended to test four hypotheses: (1) lt is expected that the depression representations in its dimensions of consequences, duration and personal control and treatment, identity, concern, emotions and disease understanding are significant predictors of adherence to therapy; (2) lt is expected that anxiety and depression levels in depressed patients are significantly and negatively correlated with the levels of adherence to therapy; (3) lt is expected that the levels of perceived social support are significantly and positively correlated with the levels of adherence to drug treatment and (4) lt is expected that the levels of spirituality are significantly and positively correlated with levels of adherence to therapy. This was a cross-sectional study with correlational design and was developed in one Hospital of the Alentejo Region, more specifically, in a Department of Psychiatry and Mental Health, with a non��random sample of 15 patients diagnosed with depression. The results partially confirmed the first hypothesis, being the representations of disease, in its dimensions of personal control, treatment control and emotions, significant predictors of adherence (more specifically, of the changes in the doses of medication). The second hypothesis was also partially confirmed, with depression being a predictor of adherence {both in the extent of oblivion and in the changes of medication doses). The third hypothesis was also partially confirmed, being the trustable alliance a quite significantly reliable predictor of adherence {in the dimension of the medication oblivion). Finally, the fourth hypothesis was equally partially confirmed, being the hope/optimism significant predictor of adherence (both in the extent of oblivion and in changing doses of medication). ln exploratory analyzes, it was verified the influence of socio-demographic variable "sex" in the cognitive representations and also in depression. The "age" also had some effect on changes to medication and social provisions. The "marital status" had effect in the counseling and in the opportunity to provide values. The clinical variables also proved to have influence. "Time sickness" had a significant effect on emotional representations, beliefs, hope/optimism and medication oblivion. The "treatment duration with medication" had effect in the disease understanding and the medication oblivion. Finally, are presented some implications of depression as well as some suggestions for future studies.

Anxiety, stress and depression in young adults with type 1 Diabetes

Introdu����o: A vida dos jovens adultos com diabetes tipo 1 (DM1) tem muitas exig��ncias e as consequ��ncias psicol��gicas da ades��o cont��nua aos aspetos do tratamento pode afetar a qualidade de vida. Objetivos: Conhecer o suporte social, satisfa����o com a vida, ansiedade, stresse e depressão nos jovens adultos com DM1. Material e M��todos: Estudo quantitativo realizado com 278 jovens adultos com DM1 (18 - 35 anos). Resultados: Os jovens consideram ter bom suporte social. A m��dia de satisfa����o com a vida �� 6,6 ��1,7 (escala 0-10). A maior parte dos jovens n��o apresenta estados persistentes de ansiedade e de excita����o e tens��o (stresse), pelo que t��m resist��ncia �� frustra����o e desilus��o. A maioria dos jovens n��o apresenta sintomas de depressão, revelando auto-estima, sentimentos positivos, motiva����o, entusiasmo e perce����o da probabilidade de alcan��ar objetivos de vida que sejam significativos. A an��lise fatorial das escalas de ansiedade, stresse e depressão permitiu encontrar 3 fatores que explicam 50% da vari��ncia total: stresse (36%), ansiedade (8%), depressão (6%). Conclus��es: Os jovens adultos com DM1 t��m bom suporte social e satisfa����o com a vida. A maior parte dos jovens n��o revela sintomas de ansiedade, stresse e depressão. O suporte social e a satisfa����o com a vida poder��o contribuir para uma boa sa��de mental.

Reducing the global burden of depression : population level analysis of intervention cost-effectiveness in 14 world regions

International evidence on the cost and effects of interventions for reducing the global burden of depression remain scarce. Aims: To estimate the population-level cost-effectiveness of evidence-based depression interventions and their contribution towards reducing current burden. Method: Primary-care-based depression interventions were modelled at the level of whole populations in 14 epidemiological subregions of the world. Total population-level costs (in international dollars or I$) and effectiveness (disability adjusted life years (DALYs) averted) were combined to form average and incremental cost-effectiveness ratios. Results: Evaluated interventions have the potential to reduce the current burden of depression by 10���30%. Pharmacotherapy with older antidepressant drugs, with or without proactive collaborative care, are currently more cost-effective strategies than those using newer antidepressants, particularly in lower-income subregions. Conclusions: Even in resource-poor regions, each DALYaverted by efficient depression treatments in primary care costs less than 1 year of average per capita income, making such interventions a cost-effective use of health resources. However, current levels of burden can only be reduced significantlyif there is a substantialincrease substantial increase intreatment coverage.

The impact of perceived stage of cancer on carers��� anxiety and depression during the patients��� final year of life

Objective: This paper explores the effects of perceived stage of cancer (PSOC) on carers' anxiety and depression during the patients' final year. Methods: A consecutive sample of patients and carers (N=98) were surveyed at regular intervals regarding PSOC, and anxiety and depression using the Hospital Anxiety and Depression Scale. Means were compared by gender using the Mann-Whitney U-test. The chi-square was used to analyse categorical data. Agreement between carers' and patients' PSOC was estimated using kappa statistics. Correlations between carers' PSOC and their anxiety and depression were calculated using the Spearman's rank correlation. Results: Over time, an increasing proportion of carers reported that the cancer was advanced, culminating at 43% near death. Agreement regarding PSOC was fair (kappa=0.29-0.34) until near death (kappa=0.21). Carers' anxiety increased over the year; depression increased in the final 6 months. Females were more anxious (p=0.049, 6 months; p=0.009, 3 months) than males, and more depressed until 1 month to death. The proportion of carers reporting moderate-severe anxiety almost doubled over the year to 27%, with more females in this category at 6 months (p=0.05). Carers with moderate-severe depression increased from 6 to 15% over the year. Increased PSOC was weakly correlated with increased anxiety and depression. Conclusions: Carers' anxiety exceeded depression in severity during advanced cancer. Females generally experienced greater anxiety and depression. Carers were more realistic than patients regarding the ultimate outcome, which was reflected in their declining mental health, particularly near the end.

Self-talk in upper primary school children : its relationship with irrational beliefs, self-esteem and depression

Self-talk, irrational beliefs, self-esteem and depression were measured in a sample of 105 elementary school children in Grades 4 to 7. Sex and grade differences in positive self-talk were found. The pattern of correlation coefficients for positive self-talk supported the substantive position that positive self-talk is positively related to self-esteem and negatively related to irrational beliefs and depression in a non-clinical sample of children. However, the same support was not forthcoming for the reverse relationships for negative self-talk. Therapeutic implications are outlined as are suggestions for future research in the area of children's self-talk.

The Children's Depression Scale : assessment of factor structure with data from a normal population

A study investigated the reliability and construct validity of the Children's Depression Scale. The revised subscales were shown to have strong construct and face validity and high reliability.

Neurocognitive profiles of people with comorbid depression and alcohol use : implications for psychological interventions

Depression and alcohol use disorders frequently co-occur and are highly prevalent. Both conditions are known to impair cognitive functioning, yet research into the role of these impairments in response to Cognitive Behaviour Therapy (CBT) is limited. The purpose of the present study was to examine the relationship between baseline neuropsychological performance, severity of depressive symptoms and alcohol use disorders. Participants with current depression and hazardous alcohol use were functioning in the average range on all neuropsychological measures prior to treatment entry. Baseline measures of drinking severity and a range of cognitive functions were inversely correlated. After controlling for other baseline variables, superior baseline cognitive functioning predicted greater reductions in depression severity after 17 weeks. These predictive effects occurred across both brief and extended interventions. Findings suggest that improvement in depression following psychological treatment is enhanced by greater fluid reasoning ability and is predicted by executive functioning, regardless of the treatment length or problem focus.

Kava Anxiety Depression Spectrum Study (KADSS): a mixed methods RCT using an aqueous extract of Piper methysticum

Objectives: To report on the design, significance and potential impacts of the first documented human clinical trial assessing the anxiolytic and thymoleptic efficacy of an aqueous monoextract of Piper methysticum (kava). The significance of the qualitative element of our clinical trial is also explored. The Kava Anxiety Depression Spectrum Study (KADSS) is a 3-week placebocontrolled, double-blind, cross-over trial involving 60 adult participants (18���65) with elevated stable anxiety and varying levels of depressive symptoms. Aims: The aims of KADSS are: (1) to determine whether an aqueous standardised extract of kava is effective for the treatment of anxiety; (2) to assess the effects of kava on differing levels of depression; and (3) to explore participants��� experience of taking kava via qualitative research. The study also provides preliminary assessment of the safety of an aqueous extract of kava in humans. Conclusion: If results reveal that the aqueous kava preparation exerts significant anxiolytic effects and appears safe, potentially beneficial impacts may occur. Data supporting a safe and effective kava extract may encourage a re-introduction of kava to Europe, UK and Canada. This may provide a major socioeconomic benefit to Pacific Island nations, and to sufferers of anxiety disorders.