Study of the psychometric qualities of the Brief Social Phobia Scale (BSPS) in Brazilian university students

Purpose: To perform a psychometric analysis of the Brazilian version of the Brief Social Phobia Scale (BSPS). Materials and methods: Hundred and seventy-eight university students of both genders aged on average 21.2 years and identified as Social Anxiety Disorder (SAD) cases and non-cases was studied, with the structured clinical interview for DSM-IV being used as a parameter. The different instruments were applied in an individual manner in the presence of a rater and of an observer. Results: The BSPS showed adequate internal consistency (0.48-0.88) and concurrent and divergent validity with the Beck Anxiety Inventory (BAI) (0.21-0.62), Social Phobia Inventory (0.24-0.82) and Self Statements During Public Speaking Scale (SSPS) (0.23-0.31). Discriminative validity revealed a sensitivity of 0.88-0.90 and a specificity of 0.81(0.83 for cut-off notes of 18/19. Factorial analysis demonstrated the presence of six factors that jointly explained 71.79% of data variance. Construct validity indicated some limits of the scale regarding the diagnosis of SAD. Inter-rater reliability was strong (0.86-1.00, p < 0.001). Conclusions: The BSPS is adequate for use with university students, although further studies in different cultures, samples and contexts are still necessary. (C) 2009 Elsevier Masson SAS. All rights reserved.

The impact of stress and anxiety on the pressure pain threshold of myofascial pain patients

The purpose of this study was to evaluate the influence of stress and anxiety on the pressure pain threshold (PPT) of masticatory muscles and on the subjective pain report. Forty-five women, students, with mean age of 19.75 years, were divided into two groups: group 1:29 presenting with masticatory myofascial pain (MFP), according to the Research Diagnostic Criteria for Temporomandibular Disorders and group 2: 16 asymptomatic controls. An electronic algometer registered the pain thresholds on four different occasions throughout the academic year. To measure levels of stress, anxiety and pain, the Beck Anxiety Inventory, Lipp Stress Symptoms Inventory and Visual Analog Scale (VAS) were used. Three-way anova and Tukey`s tests were used to verify differences in PPT between groups, times and sites. Levels of anxiety and VAS were compared using Mann-Whitney test, while Friedman`s test was used for the within-groups comparison at different times (T1 to T4). The chi-squared and Cochran tests were performed to compare groups for the proportion of subjects with stress (alpha = 0.05). Differences in PPT recordings between time (P = 0.001) and sites (P < 0.001) were detected. Higher levels of anxiety and lower PPT figures were detected at T2 (academic examination) (P = 0.001). There was no difference between groups for anxiety and stress at any time (P > 0.05). The MFP group also has shown significant increase of VAS at the time of academic examination (P < 0.001). External stressors such as academic examinations have a potential impact on masticatory muscle tenderness, regardless of the presence of a previous condition such as masticatory myofascial pain.

Depressão infantil em famílias monoparentais

Dissertação de Mestrado apresentada ao ISPA - Instituto Universitário

Levantamento de sintomas depressivos em crianças e adolescentes com hemofilia

OBJETIVO: Avaliar, através da aplicação do questionário de auto-avaliação Children's Depression Inventory (CDI), a presença de sintomas depressivos, ideação suicida e medo da dor em crianças e adolescentes com hemofilia, comparando-os com um grupo-controle sem hemofilia. MÉTODOS: Aplicação do CDI em 40 crianças e adolescentes do sexomasculino, com idades entre 7 e 15 anos, sendo 20 com hemofilia e 20 do grupo-controle. RESULTADOS: O escore médio do CDI no grupo com hemofilia foi 11,55 ± 7,51 e no grupo-controle, 5,3 ± 2,7, diferença estatisticamente significativa (p = 0,0003). Ao aplicar o ponto de corte 13, 35% do grupo com hemofilia situou-se na faixa indicativa de sintomas depressivos clinicamente relevantes, enquanto no grupo-controle nenhum indivíduo situou-se nessa faixa, diferença que foi estatisticamente significativa (p = 0,008). Na análise da presença de ideação suicida, o índice do grupo com hemofilia foi 25% e no grupo-controle 10%, uma diferença estatisticamente considerada não-significativa. Na análise do medo de sentir dor, o índice no grupo de hemofílicos foi 85% e no grupo-controle 25%, diferença estatisticamente significativa (p = 0,0002). CONCLUSÕES: Crianças e adolescentes com hemofilia em nossa amostra clínica apresentam maiores índices de sintomas depressivos e mais medo de sentir dor do que crianças e adolescentes da população geral.

Sintomatologia depressiva em adolescentes iniciais: estudo de base populacional

OBJETIVO: Verificar a prevalência de sintomatologia depressiva em adolescentes entre 11 e 15 anos em Pelotas, RS, e identificar seus fatores associados. MÉTODOS: Estudo transversal de base populacional com amostra representativa de adolescentes da zona urbana da cidade de Pelotas, RS. Dos 448 setores censitários existentes no município, 79 foram aleatoriamente sorteados. Os jovens entre 11 e 15 anos localizados nestes setores foram convidados a responder o questionário auto-aplicado que continha perguntas sobre: idade, sexo, vida escolar, religião, atividades físicas, entretenimento, tabaco, consumo de álcool, uso de outras drogas, relacionamentos sexuais e conduta. Além disso, a sintomatologia depressiva dos adolescentes foi avaliada por meio da escala Children's Depression Inventory (CDI), também presente no instrumento de pesquisa. Para a análise dos dados foi utilizada a regressão logística ajustada ao modelo hierárquico. RESULTADOS: A prevalência de depressão foi de 2,1%. Após a regressão logística ajustada ao modelo hierárquico, estiveram significativamente associados à depressão: baixa condição socioeconômica, histórico de fracasso acadêmico, ausência de prática religiosa, abuso de álcool nos últimos 30 dias e indicativo de transtorno de conduta. CONCLUSÃO: É evidenciada a necessidade de programas preventivos e integrados de política na adolescência para depressão e comportamentos de risco à saúde.

Acomodação familiar e criticismo percebido em pacientes com transtorno obsessivo-compulsivo

OBJETIVO: O transtorno obsessivo-compulsivo (TOC) causa importante impacto sobre a dinâmica familiar. Frequentemente, ocorrem modificações na rotina da família, a qual acaba se adaptando aos sintomas e às exigências do paciente, fenômeno denominado acomodação familiar. Portadores de TOC podem sentir-se, ainda, alvo de críticas por parte de pessoas de seu convívio. Alguns estudos associam pior prognóstico a maiores Índices de Acomodação Familiar e criticismo percebido. Este artigo tem como objetivo verificar possíveis associações entre tipos de sintomas predominantes (dimensões) determinados pela escala DYBOCS, em relação ao funcionamento familiar e percepção crítica dos pacientes. MÉTODO: Quarenta e nove pacientes e seus familiares foram avaliados por meio da aplicação de escalas para medição dos índices de criticismo percebido (Perceived Criticism Scale) e acomodação familiar (Family Accommodation Scale), além de escalas para medir a intensidade dos sintomas obsessivo-compulsivos (Dimensional Yale-Brown Obsessive-Compulsive Scale, Yale-Brown Obsessive-Compulsive Scale), depressivos e ansiosos (Hamilton and Beck depression and anxiety inventories). Compararam-se os resultados aos índices obtidos pela DYBOCS e a outras variáveis clínicas relacionadas ao TOC. RESULTADOS: Encontraram-se correlações estatísticas entre gravidade das dimensões agressividade e contaminação, com maior acomodação familiar. Foi verificado também maior criticismo por parte dos pacientes portadores de colecionismo. CONCLUSÃO: Diferentes subtipos de TOC exercem diferentes padrões de influência no contexto familiar. Mais estudos com esse enfoque são necessários para melhor orientação comportamental a pacientes e familiares.

Validação da versão em português do Inventário de Depressão Maior

OBJETIVO: Validar, adaptar e aferir a fidedignidade do Inventário de Depressão Maior (Major Depression Inventory - MDI) para a língua portuguesa. MÉTODOS: O questionário passou pelo processo de adaptação transcultural. Foi realizado um pré-teste para avaliar sua aplicabilidade. Para avaliação de reprodutibilidade, utilizou-se medida repetida com intervalo de 1 a 2 semanas e coeficiente de correlação intraclasse. O MDI e a escala de Hamilton foram aplicados em 30 pacientes com diagnóstico de depressão, que foram pareados com 90 controles aos quais foi aplicado o MDI. A curva ROC foi realizada com 120 pacientes e escore final do MDI. Para análise da validade interna, utilizou-se o alfa de Cronbach. RESULTADOS: Sensibilidade e especificidade foram 0,86 e 0,75, respectivamente, com escores 16/17. O alfa de Cronbach para a escala total foi 0,91. O coeficiente de Pearson entre o total do MDI e o total da escala de depressão de Hamilton foi 0,56. A análise fatorial revelou dois fatores: o primeiro explicava 53,9% da variação enquanto o segundo explicava somente 13,6%. A confiabilidade teste-reteste foi excelente (com coeficiente de correlação intraclasse variando de 0,50 e 0,93 para itens individuais e 0,90 para o escore total). CONCLUSÃO: As propriedades psicométricas do MDI se mostraram adequadas para aplicação na população brasileira, entretanto outros estudos se fazem necessários.

Low prevalence of behavioural and emotional problems among Swiss paediatric patients with inflammatory bowel disease.

OBJECTIVES: Whether behavioural and emotional maladjustment is more prevalent in children with inflammatory bowel disease (IBD) than in healthy controls remains controversial. The aim of this study was to assess paediatric IBD patients for problems with emotional and behavioural adjustment and to examine associations with clinical and demographic variables. METHODS: Data from paediatric patients with IBD enrolled in the Swiss IBD Cohort Study and the results of both the parent-rated Strengths and Difficulties Questionnaire (SDQ) and the self-reported Child Depression Inventory (CDI) were analysed. Of the 148 registered patients, 126 had at least one questionnaire completed and were included. RESULTS: The mean age of 71 patients with Crohn's disease (44 males, 27 females) was 13.4 years, and 12.8 years for the 55 patients with ulcerative or indeterminate colitis. The mean duration of disease was 1.2 and 2.7 years, respectively. The total score of the SDQ was abnormal in 11.4% of cases compared to 10% in the normal population. Abnormal sub-scores were found in 20.2% of subjects for the domain of emotional problems and in 17.1% for problems with peers. The total CDI T score indicated a significantly lower prevalence of clinical depression in IBD patients than in normal youth. No correlation between the total SDQ scores or the CDI T scores and gender, type or duration of IBD, inflammatory markers or disease scores was found. CONCLUSIONS: The prevalence of problems with behavioural and emotional adjustment among Swiss paediatric IBD patients is low and comparable to that of the normal population.

Predictors and Correlates of Substance Use among Young Men. The Longitudinal “From a Boy to a Man” Birth Cohort Study.

Substance use is one of our most important public health problems. Studying risk factors in a longitudinal study setting helps to identify subgroups of young people at greater risk for substance-use-related problems, and to facilitate targeted prevention efforts. The aim of this thesis was to study childhood predictors and correlates of substance-use-related outcomes among young men in a longitudinal, nationwide birth cohort study. The study population included 10% of all Finnish-speaking boys born in Finland in 1981 (n=2946, 97% of the target population). In 1989, at age eight, valid measures of psychiatric symptoms (Rutter questionnaires and Children’s Depression Inventory) were obtained from parents, teachers and the boys themselves. In 1999, at age 18, boys were reached at their obligatory military call-up (n=2348, 80% of the boys attending the study in 1989). Self-reports of substance use, psychopathology, adaptive functioning (Young Adult Self-Report), and mental health service use were obtained through questionnaires. Information about psychiatric diagnoses from the Military Register (age 18-23 years) and information about offending from the National Police Register (age 16-20 years) were collected in early adulthood (92% of the 1989sample). Boys with childhood conduct, hyperactive, and comorbid conduct-emotional problems had elevated rates of substance use and substance-use-related crime in early adulthood. Depressive symptoms predicted daily smoking, especially among boys of low-educated fathers. Emotional problems predicted lower occurrence of drunkenness-related alcohol use and smoking. Teacher reports on boys’ problem behaviour had the best predictive power for later substance use. At age 18, frequent drunkenness associated with delinquency, smoking and illicit drug use, and having friends. Occasional drunkenness associated with better psychosocial functioning in general compared to boys with frequent drunkenness or without drunkenness-related alcohol use. Illicit drug use without drug offending was not predicted by childhood psychiatric symptoms, but 22% of boys with illicit drug use had a psychiatric diagnosis in early adulthood. Drug offenders, in turn, had psychiatric problems both in childhood and in adulthood. Psychiatric disorders were common among young men with substance-use-related crime. Recidivist crime associated strongly with having a substance use disorder diagnosis according to the Military Register. At age 18, frequent drunkenness was common among boys entering mental health services, but entering substance use treatment was non-existent. According to the findings of this thesis, substance-use-related outcomes accumulate in boys having psychiatric problems both in childhood and in early adulthood. Targeted early interventions in school health care systems, particularly for boys with childhood hyperactive, conduct, and comorbid conduct-emotional problems are recommended. Psychiatric problems and risky behaviours, such as delinquency should always be assessed alongside substance use. Specialized and multidisciplinary care are required for young men who have multiple or complex needs, for instance, for young men with drug offending and recidivist crime. Integrating a substance use treatment perspective with other services where young men are encountered is emphasized.

Cribatge de simptomatologia depressiva en població universitària catalana : associació amb perfil de personalitat i branca de coneixement dels estudis cursats

La simptomatologia depressiva és una problemàtica incapacitant i freqüent en la població dels països occidentalitzats, tot i que existeix notable disparitat entre les xifres aportades per diferents treballs. Al nostre entorn, a més, no ha estat estudiada en població universitària. La relació de la simptomatologia depressiva amb determinats trets de personalitat, fonamentalment el neuroticisme, ha estat reportada àmpliament en la literatura; tanmateix, no existeixen estudis recents en el nostre entorn, i també hi ha incertesa en la relació entre personalitat i tipologia d’estudis universitaris. Estudi descriptiu transversal amb una mostra de 156 estudiants de primer curs de les branques de coneixement d’enginyeries, humanitats, ciències socials i ciències de la salut de la Universitat Autònoma de Barcelona, els quals han estat avaluats amb el Beck Depression Inventary (BDI) i el test de personalitat NEO PI-R

Reframing video gaming and internet use addiction : empirical cross-national comparison of heavy use over time and addiction scales among young users

BACKGROUND AND AIMS: Evidence-based and reliable measures of addictive disorders are needed in general population-based assessments. One study suggested that heavy use over time (UOT) should be used instead of self-reported addiction scales (AS). This study compared UOT and AS regarding video gaming and internet use empirically, using associations with comorbid factors. DESIGN: Cross-sectional data from the 2011 French Survey on Health and Consumption on Call-up and Preparation for Defence-Day (ESCAPAD), cross-sectional data from the 2012 Swiss ado@internet.ch study and two waves of longitudinal data (2010-13) of the Swiss Longitudinal Cohort Study on Substance Use Risk Factors (C-SURF). SETTING: Three representative samples from the general population of French and Swiss adolescents and young Swiss men, aged approximately 17, 14 and 20 years, respectively. PARTICIPANTS: ESCAPAD: n =22 945 (47.4% men); ado@internet.ch: n =3049 (50% men); C-SURF: n =4813 (baseline + follow-up, 100% men). MEASUREMENTS: We assessed video gaming/internet UOT ESCAPAD and ado@internet.ch: number of hours spent online per week, C-SURF: latent score of time spent gaming/using internet] and AS (ESCAPAD: Problematic Internet Use Questionnaire, ado@internet.ch: Internet Addiction Test, C-SURF: Gaming AS). Comorbidities were assessed with health outcomes (ESCAPAD: physical health evaluation with a single item, suicidal thoughts, and appointment with a psychiatrist; ado@internet.ch: WHO-5 and somatic health problems; C-SURF: Short Form 12 (SF-12 Health Survey) and Major Depression Inventory (MDI). FINDINGS: UOT and AS were correlated moderately (ESCAPAD: r = 0.40, ado@internet.ch: r = 0.53 and C-SURF: r = 0.51). Associations of AS with comorbidity factors were higher than those of UOT in cross-sectional (AS: .005 ≤ |b| ≤ 2.500, UOT: 0.001 ≤ |b| ≤ 1.000) and longitudinal analyses (AS: 0.093 ≤ |b| ≤ 1.079, UOT: 0.020 ≤ |b| ≤ 0.329). The results were similar across gender in ESCAPAD and ado@internet.ch (men: AS: 0.006 ≤ |b| ≤ 0.211, UOT: 0.001 ≤ |b| ≤ 0.061; women: AS: 0.004 ≤ |b| ≤ 0.155, UOT: 0.001 ≤ |b| ≤ 0.094). CONCLUSIONS: The measurement of heavy use over time captures part of addictive video gaming/internet use without overlapping to a large extent with the results of measuring by self-reported addiction scales (AS). Measuring addictive video gaming/internet use via self-reported addiction scales relates more strongly to comorbidity factors than heavy use over time.

Comorbilidad entre los factores de ansiedad del SCARED y la sintomatología depresiva en niños de 8-12 años

El objetivo de este estudio fue examinar la comorbilidad entre los factores de ansiedad del SCARED y síntomas depresivos en niños de 8-12 años. 792 niñas y 715 niños completaron el Screen for Child Anxiety Related Emotional Disorder (SCARED), el Children’s Depression Inventory (CDI) y un cuestionario de datos sociodemográficos. El 47% de la muestra presentó síntomas ansiosos y el 11,5% presentó síntomas depresivos. La comorbilidad heterotípica fue del 82% en niños con riesgo de depresión y del 20% en niños con riesgo de ansiedad. La comorbilidad homotípica entre los factores de ansiedad fue del 87%. La comorbilidad homotípica y heterotípica fueron elevadas, su detección hará posible prevenir la continuidad de un trastorno de ansiedad y el desarrollo de depresión

Psychological and Family Factors Associated with Suicidal Ideation in Pre-Adolescents

To assess the psychological and family factors associated with suicidal ideation in preadolescent children, we studied a sample of 361 students, average age 9 years old. Twogroups were formed, on the basis of the presence (n = 34) or absence (n = 44) of suicidal ideation. Suicidal ideation was assessed with the Children’s Depression Inventory and the Children’s Depression Rating Scale-Revised. Depression, hopelessness, self-esteem, and perceived family environment were compared in both the suicidal ideation and the control groups. Students with suicidal ideation generally presented greater depressive symptoms and hopelessness, and lower self-esteem and family expressiveness, although there weredifferences both between sexes, and when the variable depression was controlled. Identifying these risk factors in pre-adolescents may have an impact on prevention of suicidal behavior at higher risk ages

Nuorisorikollisuuden esiintyvyys, taustatekijät ja sovittelu

Tausta Vaikka nuorisorikollisuus on kriminologisen tutkimuksen perinteinen kohde, on edelleen tarvetta pitkittäistutkimuksille, joissa on laaja, koko väestöä edustava otos. Kriminaalipolitiikan alalla puolestaan rikosten sovittelu ja muut restoratiivisen oikeuden muodot ovat nousseet Suomessakin haastamaan perinteiset rikoskontrollin paradigmat, rangaistuksen ja hoidon. Tutkimuskysymykset Tutkimuksen pääkysymyksenä oli, mitkä lapsuudessa (8 v.) ja nuoruudessa (18 v.) mitatut psykososiaaliset tekijät ovat yhteydessä nuorisorikollisuuden (16-20 v.) määrään ja lajiin. Lisäksi yhtenä kysymyksenä oli, miten varusmiespalvelun aikaiset psykiatriset diagnoosit liittyvät nuorisorikollisuuteen. Lisäksi tutkimme nuorisorikollisuuden esiintyvyyttä ja palvelujen käyttöä, ja vertailimme eri informanttien (tutkimushenkilöt itse, vanhemmat ja opettajat) vastausten ennusvoimaa lasten tulevan rikollisuuden suhteen. Rikosten sovittelun osalta kysymyksenä oli, miten suomalainen sovittelukäytäntö vastaa restoratiivisen oikeuden teoriaa ja miten sovittelua pitäisi kehittää. Aineisto ja metodit Pitkittäistutkimuksemme aineistona oli valtakunnallisesti edustava satunnaisotos, joka vastasi 10% vuonna 1981 Suomessa syntyneistä suomenkielisistä pojista. Ensimmäinen tiedonkeruu tapahtui 1989, kun pojat olivat 8-vuotiaita. Tietoa kerättiin lomakekyselyin pojilta itseltään sekä heidän vanhemmiltaan ja opettajiltaan. Tietoja saatiin 2946 pojasta. Lasten lomakkeena oli Children’s Depression Inventory, vanhemman lomakkeena Rutter A2 ja opettajan lomakkeena Rutter B2. Toinen tiedonkeruu järjestettiin, kun pojat osallistuivat kutsuntoihin 1999. Tietoja saatiin 2330 pojasta. Lomakkeena oli Young Adult Self-Report . Puolustusvoimien rekisteristä saatiin tiedot poikien kutsunnoissa ja palvelusaikana (vuosina 1999-04) saamista psykiatrisista diagnooseista, jotka luokiteltiin kuuteen luokkaan: antisosiaalinen persoonallisuushäiriö, päihdehäiriöt, psykoottiset häiriöt, ahdistuneisuushäiriöt, masennustilat ja sopeutumishäiriöt. Tieto mahdollisesta diagnoosista saatiin 2712 pojasta. Rikollisuus operationalisoitiin poliisin ns. RIKI-rekisteriin vuosina 1998-2001 rekisteröityjen tekojen avulla, kun pojat olivat pääasiassa 16-20-vuotiaita. Rikosten määrän mukaan pojat jaettiin neljään ryhmään: ei rikoksia, 1-2 rikosta (satunnainen rikollisuus), 3-5 rikosta (uusintarikollisuus) ja yli 5 rikosta (aktiivinen uusintarikollisuus). Rikoslajeista muodostettiin viisi kategoriaa: huume-, väkivalta-, omaisuus-, liikenne- ja rattijuopumusrikollisuus. Analyysivaiheessa rekisteridatasta poistettiin liikennerikkomukset. Kaikkiaan tiedot mahdollisista poliisikontakteista saatiin 2866 pojasta. Sovitteludata koostui 16 sovittelujutun havainnoinnista Turussa vuosina 2001- 2003. Tulokset Kaikkiaan 23% pojista oli rekisteröity rikoksesta (poissulkien liikennerikkomukset) nelivuotisen tutkimusperiodin aikana 16-20-vuotiaana. Satunnaisia rikoksentekijöitä oli 15%, uusijoita 4% ja moninkertaisia uusijoita 4%. Rikokset kasautuivat moninkertaisille uusijoille: tämä 4%:n ryhmä teki 72% kaikista rikoksista . Omaisuus- ja liikennerikollisia oli eniten (kumpiakin 11%), ja huumerikollisia vähiten (4%). Kaikki rikoslajit korreloivat keskenään tilastollisesti merkitsevästi. Nuorisorikollisuuden itsenäisiä ennustekijöitä lapsuudessa olivat rikkinäinen perherakenne, vanhempien alhainen koulutustaso, lapsen käytösongelmat ja hyperaktiivisuus. Kun verrattiin eri informantteja (lapset itse ja heidän vanhempansa ja opettajansa), etenkin opettajien vastaukset ennustivat lasten tulevaa rikollisuutta. Nuoruudessa rikollisuuden itsenäisiä korrelaatteja olivat pienellä paikkakunnalla asuminen, vanhempien ero, seurustelu, itse ilmoitettu antisosiaalisuus ja säännöllinen tupakointi ja humalajuominen. Ennus- ja taustatekijöille oli tyypillistä se, että ne olivat lineaarisessa yhteydessä rikosten määrään (ongelmat ja rikosten määrä lisääntyivät käsi kädessä) ja että ne liittyivät useaan rikoslajiin yhtä aikaa. Huumerikollisuudella oli kuitenkin vähemmän itsenäisiä ennus- ja taustatekijöitä kuin muilla rikoslajeilla. Joka kymmenes poika kärsi psykiatrisista häiriöistä. Tämä ryhmä teki noin puolet kaikista rikoksista, ja lähes joka toinen poika, jolla oli psykiatrinen häiriö, oli rekisteröity rikoksista. Rikolliseen käytökseen liittyivät etenkin antisosiaalinen persoonallisuushäiriö ja päihdehäiriöt. Masennustilat olivat kuitenkin ainoa diagnoosiryhmä, joka ei ollut yhteydessä rikollisuuteen. Myös psykiatristen häiriöiden esiintyvyys kasvoi lineaarisesti rikosten määrän kanssa; aktiivisista uusintarikollisista yli puolella (59%) oli psykiatrinen diagnoosi. Rikollisuuden lisäksi erilaiset psykososiaaliset ongelmat kasautuivat pienelle vähemmistölle. Aktiivisten uusijoiden ryhmään olivat tilastollisesti merkitsevästi yhteydessä lähes kaikki ongelmat mitä tutkimme. Kuitenkin tästä ryhmästä vain alle 3% oli käyttänyt mielenterveyspalveluja viimeisen vuoden aikana. Rikossovittelun havainnointitutkimuksen perusteella sovittelussa monet perusasiat ovat kunnossa, ja toiminta on mielekästä niin asianosaisten kuin yhteiskunnankin kannalta. Useimmiten osapuolet kohtasivat ja saivat aikaan sopimuksen, johon he vaikuttivat tyytyväisiltä. Rikoksentekijät olivat motivoituneita korvaamaan aiheuttamansa vahingot. Osapuolet saivat kertoa tarinansa omin sanoin, heitä kuunneltiin ja he ymmärsivät mitä sovittelussa puhutaan ja sovitaan. Sovittelun kuluessa jännitys väheni ja asiat saatiin loppuunkäsiteltyä. Asianosaiset saivat vaikuttaa prosessiin ja sopimukseen, ja uhrin oikeudet olivat sovittelussa keskeisellä sijalla. Restoratiivisen teorian perusteella sovittelussa havaittiin myös kehittämisen varaa: Etenkin nuoria rikoksentekijöitä oli hankala saada osallistumaan tosissaan, ja aikuiset helposti hallitsivat keskustelua. Etukäteistapaamisia ja tukihenkilöitä ei juuri hyödynnetty. Sovitteluja hallitsi puhe sopimuksesta ja rahasta. Työkorvauksia ei käytetty eikä rehabilitaatiota käsitelty. Sekä sovitteluun pääsy että sovittelumenettely riippuivat yksittäisistä henkilöistä. Johtopäätökset Rikosten tekeminen nuoruudessa on melko yleistä ja monimuotoista. Rikokset ja psykososiaaliset ongelmat kasautuvat pienelle ryhmälle ja kulkevat käsi kädessä. Myös psykiatriset häiriöt ovat lineaarisessa yhteydessä rikosten määrään. Rikosriskiä voidaan ennustaa jo lapsuudessa, ja etenkin opettajat ovat tarkkanäköisiä lasten ongelmien suhteen. Eri rikoslajeilla on varsin samanlaisia taustatekijöitä. Aktiiviset rikoksentekijät vastaavat suuresta osasta kokonaisrikollisuutta, tarvitsevat eniten apua, mutta eivät kuitenkaan hakeudu psykososiaalisten palvelujen piiriin. Rikosten sovittelu tarjoaa keinon puuttua ongelmiin varhaisessa vaiheessa ilman leimaamista. Sovittelun kehitystehtävät liittyvät etenkin dialogiin, valmisteluihin, tukihenkilöihin, työkorvauksiin, palveluunohjaukseen ja sovittelun sovellusalaan. Sovittelua ja muita restoratiivisia menettelyjä on kehitettävä ja laajennettava esimerkiksi niin, että niitä voitaisiin käyttää palveluunohjauksen välineenä.

Relationship between anxiety and overactive bladder syndrome in older women

PURPOSE: The objective of this study was to investigate the relationship between overactive bladder syndrome and anxiety in older women.METHODS: Of the 198 older women who were invited, 29 were excluded and 166 were then divided into two groups according to the Advanced Questionnaire of Overactive Bladder (OAB-V8): one group with overactive bladder symptoms (OAB-V8≥8) and the other without the symptoms of an overactive bladder (OAB-V8<8). The purpose was to conduct a frequency analysis and to investigate the relation of the social demographic data and anxiety in the two groups. The Beck Anxiety Inventory (BAI) was used to evaluate the level of anxiety. The Kolmogorov-Smirnov test was used to determine the distribution of the data. The differences between the two groups for the continuous variables were analyzed by the Mann-Whitney U test, the differences for the categorical variables were analyzed by the Chi-Square test and the association between the continuous variables was analyzed by the Spearman Correlation test. The tests were two-tailed with a confidence level of 5%.RESULTS: Overall, the frequency of an overactive bladder was present in 117 (70.5%) of the participants. The body mass index (BMI) of the group with overactive bladder symptoms was significantly higher than the BMI of those without these symptoms (p=0.001). A higher prevalence of mild, moderate and severe anxiety was observed among older women with overactive bladder symptoms. In addition, the overactive bladder symptoms group presented a positive low correlation with anxiety symptoms (r=0.345) and with BMI (r=0.281). There was a small correlation between BMI and anxiety symptoms (r=0.164).CONCLUSIONS: Overactive bladder syndrome was prevalent among older women and the existence of these symptoms was linked to the presence of mild, moderate and/or severe anxiety symptoms.