957 resultados para great depression
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The start of university is presented as a crucial stage in the life of the student. If, on the one hand, it is a period of increased autonomy and freedom, on the other, it is a period that also increases the sense of responsibility and self discipline. In this study, based on a quantitative approach, we identified the main risk situations experienced by freshmen at the University of Evora, by applying a questionnaire developed for this purpose and the Beck inventory. Key findings are highlighted, such as the consumption of harmful substances (tobacco, alcohol and illicit drugs), whose values exceed the average population. The consumption of alcoholic beverages begins early and is continuous and excessive. Also, the presence of symptoms compatible with dysphoria and depression is noted in about 9% of students. Self-medication practices were found in 58.7% of the freshmen. Our findings reveal the need for preventive intervention by health professionals, due to these young people’s great exposure to health risks.
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Aphasia is a chronic acquired communication disorder that may change people with aphasia (PWA) and their caregivers’ lives for ever. Social and emotional changes are frequently reported by both, although the impact of these changes in quality of life (QOL) needs further research. This study identifies predictors and variables that influence PWA’s and their caregivers’ QOL and social relationships (SR). A cross-sectional descriptive, correlational and comparative study was undertaken with 255 individuals from Portuguese general population (mean age 43 years, range 25-84 years; 148 females, 107 males), 25 PWA (mean age 54 years, range 20-71; 12 females and 13 males), and 25 caregivers (mean age 51 years, range 26-73; 17 females and 8 males). All the participants completed the World Health Quality of Life Bref instrument, the SR domain of the World Health Organization Quality of Life – 100 scale, and the Center for Epidemiologic Studies Depression Scale. Participants with aphasia completed the Lisbon Aphasia Assessment Battery, Barthel Index, Frenchay Activities Index, Communication Disability Profile and the Modified Mini-Mental State which evaluated language disability, aphasia coefficient, activities, participation and cognition. In addition, caregivers completed the Carers’ Assessment of Managing Index to assess coping strategies. PWA and their caregivers are less satisfied with their QOL and SR than Portuguese general population; whereas PWA have the worse QOL and SR. Thus, aphasia seems to impact negatively in their QOL and SR. Emotional status has great importance for QOL and SR among the three groups. PWA’s activities and participation have great impact in both PWA’s and caregivers’ QOL and SR. Additionally, emotional status and participation are the best predictors of PWA’s QOL. Along with these two variables, activities of the PWA are the best predictors of caregivers’ QOL. Participation is the best predictor of PWA’s SR; emotional status and number of cohabitants are best predictors for caregivers’ SR. Aphasia assessment and intervention should take into account all the factors that influence PWA’s and caregivers’ QOL and SR so the central goal of enhancing it can be achieved. These results are important for identifying and planning support needs and are useful in the orientation of the activities carried out by the service providers allowing the adjustment of health programs and policies based on people’s real life needs.
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Psychological symptoms are common among burn survivors. However, knowledge about epidemiology and predictors of psychopathology has shown great heterogeneity in this population. The Fenix-II Project was the first epidemiological study on the psychopathological consequences of burn injuries developed in Spain, providing a detailed analysis of the progression of psychological symptoms during the first six months after injury. Three hundred and thirty-three patients were monitored and 183 were included in this study. Posttraumatic, depression and anxiety symptoms showed a general decreasing tendency across time. At 6 months, 34 patients showed clinically significant Posttraumatic Stress Disorder (PTSD) symptoms (20.5% of 166 patients reached at 6 months) as measured with the MINI Neuropsychiatric Interview. Within this group of patients, anxiety, depression and hyperarousal increased at 30 days, and avoidance 90 days after injury. The most accurate predictors of PTSD were found to be being burned in a Motor Vehicle Accident, risk of social exclusion, low body-image adjustment, anterior trunk location of the burn injury and life threat perception during the burn-shock period. Considering these factors, clinicians may identify patients at risk of PTSD development, allowing an adequate follow up and preventive interventions which may minimize the psychological consequences of burn injuries.
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Aims: To determine whether older people are prescribed antidepressants at lower levels of depression and with fewer symptoms, and whether they are more likely to engage in chronic usage. Methods: An online survey about experiences with, and opinions about, depression and antidepressants, was completed by 1,825 New Zealand adults who had been prescribed antidepressants in the preceding five years. Results: Participants over 55 were prescribed antidepressants with significantly fewer symptoms and were significantly less likely to meet DSM criteria for depression. They were also significantly more likely to have used the drugs for three years and still be using them. Conclusions: Prescribing physicians and their older patients might benefit from discussing the pros and cons of antidepressants (including the additional risk factors with this age group) and the alternatives; and, if prescription does occur, careful monitoring to avoid unnecessary, potentially damaging, long-term use is recommended.
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Vorstellung und Kritik der Therapiesoftware 'Overcoming Depression'.
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The continued growth in the volume of international trade poses considerable economic and sustainability challenges, particularly as transport routes become more congested and concern grows about the role of transport movements in accelerating climate change. Rail freight plays a major role in the inland transport of containers passing through the main British container ports, and potentially could play a more significant role in the future. However, there is little detailed understanding of the nature of this particular rail market, especially in terms its current operating efficiency. This paper examines container train service provision to/from the four main ports, based on analysis of a representative survey of more than 500 container trains between February and August 2007. The extent to which the existing capacity is utilised is presented, and scenarios by which the number of containers carried could be increased without requiring additional train service provision are modelled, to identify the theoretical potential for greater rail volumes. Finally, the paper identifies the challenges involved in achieving higher load factors, emphasising the importance both of wider supply chain considerations and government policy decision-making.
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Tese de mestrado, Cuidados Paliativos, Faculdade de Medicina, Universidade de Lisboa, 2015
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Thesis (Master's)--University of Washington, 2015
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In 1968, Herbert Marcuse believed that a Great Refusal was possible, one that would deny the exploitative power of corporate capitalism. Marcuse's vision was never realised. This essay argues that society today is in an advanced state of that which the Frankfurt School termed repressive desublimation and questions whether a liberationary praxis is still possible. It claims that Bret Easton Ellis's fiction choreographs an internalising of the forms of critique that marked 1968 and about which Marcuse writes. It is Ellis's act of double voicing that allows him to develop a duplicitous recalcitrant voice within the state of assimilation and it is double voicing which emerges as the key technique in Ellis's work that effects an ongoing critique in commodity society. Looking at Slavoj iek's recent revisionism of the notion of repressive desublimation, which connects Marxism and psychoanalysis, the essay considers how Ellis's novels, American Psycho, Glamorama and Lunar Park, function to address and reconfigure the relationship between the status of the Marxist fetishised object and the psychoanalytic phobic object in the present-day era of late capitalism. This essay seeks to illuminate how Ellis's fiction, through an involution of Marcuse's political theories, enacts a contemporary refusal from within the state of reification.
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GOALS OF WORK: Recent literature has indicated the need for rapid evaluation of psychosocial issues secondary to cancer. Because of the problems of routine use of psychometric instruments, short instruments such as visual analogue scales or one-item 0-10 scales have been developed as valid assessment alternatives. PATIENTS AND METHODS: A study was conducted to examine the role of two 0-10 scales in measuring emotional stress (distress thermometer, DT) and depressed mood (mood thermometer, MT), respectively, in a multicenter study carried out in southern European countries (Italy, Portugal, Spain, and Switzerland). A convenience sample of 312 cancer outpatients completed the DT and MT and the Hospital Anxiety Depression Scale (HADS). MAIN RESULTS: DT was more significantly associated HADS anxiety than HADS depression while MT was related both to HADS anxiety and depression. The correlation of MT with HADS was higher than DT. A cutoff point >4 on the DT maximized sensitivity (65%) and specificity (79%) for general psychosocial morbidity while a cutoff >5 identified more severe "caseness" (sensitivity=70%; specificity=73%). On the MT, sensitivity and specificity for general psychosocial morbidity were 85% and 72% by using the cutoff score >3. A score >4 on the MT was associated with a sensitivity of 78% and a specificity of 77% in detecting more severe caseness. CONCLUSIONS: Two simple instruments, the DT and the MT, were found to have acceptable levels of sensitivity and specificity in detecting psychosocial morbidity. Compared to the HADS, however, the mood MT performed better than the DT.
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Background Hippocampal neurogenesis has been suggested as a downstream event of antidepressants (AD) mechanism of action and might explain the lag time between AD administration and the therapeutic effect. Despite the widespread use of AD in the context of Major Depressive Disorder (MDD) there are no reliable biomarkers of treatment response phenotypes, and a significant proportion of patients display Treatment Resistant Depression (TRD). Fas/FasL system is one of the best-known death-receptor mediated cell signaling systems and is recognized to regulate cell proliferation and tumor cell growth. Recently this pathway has been described to be involved in neurogenesis and neuroplasticity. Methods Since FAS -670A>G and FASL -844T>C functional polymorphisms never been evaluated in the context of depression and antidepressant therapy, we genotyped FAS -670A>G and FASL -844T>C in a subset of 80 MDD patients to evaluate their role in antidepressant treatment response phenotypes. Results We found that the presence of FAS -670G allele was associated with antidepressant bad prognosis (relapse or TRD: OR=6.200; 95% CI: [1.875–20.499]; p=0.001), and we observed that patients carrying this allele have a higher risk to develop TRD (OR=10.895; 95% CI: [1.362–87.135]; p=0.008).Moreover, multivariate analysis adjusted to potentials confounders showed that patients carrying G allele have higher risk of early relapse (HR=3.827; 95% CI: [1.072–13.659]; p=0.039). FAS mRNA levels were down-regulated among G carriers, whose genotypes were more common in TRD patients. No association was found between FASL-844T>C genetic polymorphism and any treatment phenotypes. Limitations Small sample size. Patients used antidepressants with different mechanisms of action. Conclusion To the best of our knowledge this is the first study to evaluate the role of FAS functional polymorphism in the outcome of antidepressant therapy. This preliminary report associates FAS -670A>G genetic polymorphism with Treatment Resistant Depression and with time to relapse. The current results may possibly be given to the recent recognized role of Fas in neurogenesis and/or neuroplasticity.
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Mental health constitutes a significant share of the global burden of disease. It is shaped to a great extent by socioeconomic factors and is vulnerable to external shocks. The recent financial crisis brought about stressors prone to trigger and aggravate mental illnesses. This project presents a micro analysis of the effect of the economic crisis on mental health in eleven European countries, through the estimation of individual health production functions accounting for socioeconomic controls and macroeconomic indicators. We find that mental health has deteriorated since 2007, even though the development of depression episodes is unchanged. Additionally, his variation can be partially attributed to economic recession and budgetary cuts in health spending.