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Depressão pós-parto e percepção de suporte social durante a gestação 产后抑郁与怀孕期间社会支持的感知
Pub Date : 2011-07-29 DOI: 10.1590/S0101-81082011005000010
Caroline Elizabeth Konradt, Ricardo Gonçalves da Silva, Karen Jansen, Daniela Martins Vianna, Luciana de Avila Quevedo, Luciano Dias de Mattos Souza, Jean Pierre Oses, R. Pinheiro
OBJECTIVE: To assess the impact of low perceived social support during pregnancy as a risk factor for depression within 30 to 60 days postpartum. METHOD: This cohort study included pregnant women treated at public hospitals (Brazilian Unified Health System) in the city of Pelotas, state of Rio Grande do Sul, southern Brazil. Postpartum depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Women with scores ≥ 13 points were considered to be depressed. RESULTS: Of the total of 1,019 women assessed, 168 (16.5%) presented postpartum depression. Women who did not receive support from their partners (p = 0.000), their families (p = 0.000), and friends (p = 0.000) were at higher risk for developing postpartum depression. CONCLUSION: Our findings suggest that perceived social support during pregnancy may be a protective factor against postpartum depression.
目的:评估孕期低感知社会支持作为产后30 - 60天抑郁风险因素的影响。方法:本队列研究包括在巴西南部南巴西大德州佩洛塔斯市公立医院(巴西统一卫生系统)接受治疗的孕妇。采用爱丁堡产后抑郁量表(EPDS)评估产后抑郁。得分≥13分的女性被认为是抑郁。结果:在1019名接受评估的妇女中,168名(16.5%)出现产后抑郁。没有得到伴侣(p = 0.000)、家人(p = 0.000)和朋友(p = 0.000)支持的女性患产后抑郁症的风险更高。结论:我们的研究结果表明,孕期感知到的社会支持可能是预防产后抑郁的一个保护因素。
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引用次数: 25
Características demográficas e psicossociais associadas à depressão pós-parto em uma amostra de Belo Horizonte 贝洛奥里藏特市产后抑郁症相关的人口统计学和社会心理特征
Pub Date : 2011-07-29 DOI: 10.1590/S0101-81082011005000009
Patrícia Figueira, L. F. M. Diniz, H. C. D. S. Filho
INTRODUCTION: Postpartum depression has been the object of extensive research both because of its high prevalence and its repercussions on the mother and the infant. OBJECTIVE:To compare women with and without depression in a sample of postpartum women randomly selected at a maternity in the city of Belo Horizonte, Brazil. METHODS: A total of 245 women who gave birth at a private maternity hospital in Belo Horizonte were selected. A semi-structured interview was used for the collection of psychosocial and demographic data. Diagnosis of major depression was established using and a structured interview (Mini Neuropsychiatric Interview, MINI-Plus), based on criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). RESULTS: Of the total sample, 26.9% had a diagnosis of postpartum depression. No differences were observed in the social and demographic characteristics of depressed women (n = 66, 26,9%) and of those without depression (n = 179, 73,1%). Nevertheless, several clinical and psychosocial variables showed significant differences between the groups and were therefore associated with postpartum depression, namely previous history of depression, presence of stress or depressive/anxiety symptoms during pregnancy, postpartum complications affecting the mother or the infant, and lack of support and care in the postpartum period. CONCLUSION: The identification of factors associated with postpartum depression is important for an improved understanding of the pathophysiology of this disease and for the establishment of strategies aimed at prevention and early diagnosis.
导读:产后抑郁症一直是广泛研究的对象,因为它的高患病率和对母亲和婴儿的影响。目的:比较在巴西贝洛奥里藏特市的一个产科随机抽取的产后妇女样本中有和没有抑郁症的妇女。方法:选取在贝洛奥里藏特一家私立妇产医院分娩的245名妇女。半结构化访谈用于收集社会心理和人口统计数据。根据《精神疾病诊断与统计手册》第4版(DSM-IV)中规定的标准,使用结构化访谈(Mini神经精神病学访谈,Mini - plus)建立了重度抑郁症的诊断。结果:在总样本中,26.9%的人被诊断为产后抑郁症。抑郁症妇女(n = 66,26,9%)和无抑郁症妇女(n = 179,73,1%)的社会和人口统计学特征没有差异。然而,一些临床和社会心理变量在两组之间显示出显著差异,因此与产后抑郁有关,即以前的抑郁史,怀孕期间存在压力或抑郁/焦虑症状,影响母亲或婴儿的产后并发症,以及产后期间缺乏支持和护理。结论:确定与产后抑郁相关的因素对提高对该疾病病理生理的认识,制定预防和早期诊断策略具有重要意义。
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引用次数: 19
Adaptação transcultural da versão brasileira da escala Social Rhythm Metric-17 (SRM-17) para a população angolana 巴西版社会节奏度量量表(SRM-17)对安哥拉人口的跨文化适应
Pub Date : 2011-04-29 DOI: 10.1590/S0101-81082011005000008
Regina Lopes Schimitt, Idalina Cesaltina Ribeiro Benedito, Bruna Dedavid da Rocha, Joyce Iracema Angelo Chivia, M. Hidalgo
INTRODUCTION: Social rhythm is a concept that correlates social Zeitgebers (synchronizers) with endogenous markers of time, and can be assessed with the Social Rhythm Metric-17 (SRM-17). The aim of this study was to adapt the Brazilian version of the SRM-17 to Angolan Portuguese, comparing the two scales in samples that speak the same language but have cultural differences. METHODS: The Brazilian version of the SRM-17 was assessed by 10 Angolan students who analyzed the intelligibility of the 15 sentences contained in the instrument using a 10-cm visual analog scale and proposed changes to the text. Results were reviewed for the generation of a final Angolan version, followed by a reading test and the production of a final report. RESULTS: The final Angolan version of SRM-17 maintained an equivalence of items in relation to the Brazilian Portuguese version. The version assessed by the students showed a satisfactory degree of intelligibility and semantic equivalence in most items. However, some items presented intelligibility results below the mean total scores of the scale (8.38 ± 1.0). CONCLUSION: Although the populations of Brazil and Angola speak the same language, significant cultural differences were found between the two countries. This paper presents an instrument to assess social rhythm adapted to the Angolan culture. The cross-cultural adaptation process herein described should be continued by validating the final version of the instrument in a larger sample and by assessing operational, functional, and measure equivalence.
社会节律是一个将社会授时因子(同步者)与内源性时间标记相关联的概念,可以用社会节律指标-17 (SRM-17)进行评估。本研究的目的是将SRM-17的巴西版本改编为安哥拉葡萄牙语,在使用相同语言但具有文化差异的样本中比较两种量表。方法:10名安哥拉学生评估了SRM-17的巴西版本,他们使用10厘米视觉模拟量表分析了仪器中包含的15个句子的可理解性,并提出了对文本的修改。对结果进行了审查,以编制最后的安哥拉文本,然后进行阅读测试并编写最后报告。结果:SRM-17的最终安哥拉版本与巴西葡萄牙版本保持了项目的等效性。学生评估的版本显示,大多数项目的可理解性和语义等效程度令人满意。但部分项目的可理解性得分低于量表平均总分(8.38±1.0)。结论:虽然巴西和安哥拉的人口说同一种语言,但两国之间存在显著的文化差异。本文提出了一种评估适应安哥拉文化的社会节奏的工具。本文所描述的跨文化适应过程应该通过在更大的样本中验证仪器的最终版本,并通过评估操作、功能和测量的等效性来继续进行。
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引用次数: 1
Panorama nacional do ensino da psiquiatria nas escolas médicas brasileiras 巴西医学院精神病学教育全国概况
Pub Date : 2011-04-15 DOI: 10.1590/S0101-81082011005000006
A. C. Neto, José Cássio do Nascimento Pitta, Marco Antonio Alves Brasil, M. A. Adad, Rogério Wolf de Aguiar, Camila Ruschel Selbach, Carolina Belotto, Claudia Coral, F. L. D. P. Ramos, P. M. Simonaggio
OBJECTIVE: To determine the profile of psychiatric teaching in Brazilian medical schools, with a focus on the number of professors involved and their respective degrees, the number of disciplines devoted to psychiatry and the predominant approach (psychodynamic/clinical/other) adopted, the didactic materials employed and the teaching and learning facilities available. METHODS: The study was based on the collection of data via application of questionnaires at all medical schools registered with the Brazilian Association of Medical Education (Associacao Brasileira de Educacao Medica). RESULTS: Of the 119 Brazilian schools contacted, 85 (71%) returned the questionnaires. The number of professors graduated in psychiatry at each school varied from 1 to 5 (75.3%); of these, 1 to 2 (43.4%) had a PhD degree, 1 to 2 (45.8%) a master's degree, and 1 to 2 (57.3%) were specialists. The findings revealed that 41.2% of the schools offered two disciplines of psychiatry, with a predominantly psychodynamic/clinical approach (61.2%). At 52.9% of the schools, teaching of psychiatric topics was not restricted to the specific disciplines; 64.7% of the disciplines offered hands-on training in general clinical settings. Mean number of credit hours of psychiatric teaching along the medical program was 61-90 (26.2%), and 88.9% of the programs used books as the main choice for didactic purposes. At 83.3% of the medical schools, psychiatric teaching is graded by students at the end of each discipline. CONCLUSION: The present findings revealed an important heterogeneity in the geographic regions assessed, affecting at least 71% of the schools. New studies are warranted to advance the preliminary findings herein reported.
目的:确定巴西医学院的精神病学教学概况,重点关注涉及的教授人数及其各自的学位、专门研究精神病学的学科数量、采用的主要方法(心理动力学/临床/其他)、使用的教学材料和可用的教学设施。方法:本研究通过在巴西医学教育协会(Associacao Brasileira de Educacao Medica)注册的所有医学院进行问卷调查收集数据。结果:在联系的119所巴西学校中,85所(71%)回复了问卷。各校精神科教授毕业人数为1 ~ 5人(75.3%);其中博士1至2人(43.4%),硕士1至2人(45.8%),专科1至2人(57.3%)。调查结果显示,41.2%的学校开设了两个精神病学学科,其中以精神动力学/临床方法为主(61.2%)。在52.9%的学校,精神病学主题的教学不局限于特定学科;64.7%的学科在一般临床环境中提供实践培训。精神病学教学的平均学时数为61-90(26.2%),88.9%的课程以书籍为主要教学选择。在83.3%的医学院,精神病学教学在每个学科结束时由学生评分。结论:目前的研究结果表明,在评估的地理区域中存在重要的异质性,影响了至少71%的学校。有必要进行新的研究来推进本文的初步发现。
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引用次数: 1
Incidência de conduta violenta e antissocial em população psiquiátrica forense 法医精神病人群中暴力和反社会行为的发生率
Pub Date : 2011-04-15 DOI: 10.1590/S0101-81082011005000004
L. E. B. Telles, J. O. Folino, J. G. V. Taborda
INTRODUCTION: The consequences of violent and antisocial behaviors among psychiatric hospital inpatients are serious and may affect the treatment of the aggressor. Lack of knowledge concerning the incidence of this phenomenon and its characteristics helps perpetuate the current scenario. OBJECTIVES: To present an updated literature review on the topic, to estimate the incidence of violent and antisocial behaviors in a mental hospital population, and to describe the implementation of a systematic method to record this phenomenon. METHOD: A cohort was selected among the psychiatric inpatients at Mauricio Cardoso Forensic Psychiatry Institute (Instituto Psiquiatrico Forense Mauricio Cardoso, IPFMC). Yudofsky's Overt Aggression Scale (OAS) and Tengstrom et al.'s Follow-Up Questionnaire were used. During a 1-year follow-up period, episodes of violent and antisocial behavior were evaluated daily and recorded on both the scale and the questionnaire. The population sample included 68 male patients randomly selected among the committed inpatients at IPFMC. RESULTS: The incidence of violent/antisocial behavior along the period assessed was 200 episodes involving 50 patients. Aggressions and antisocial behavior occurred mainly in daytime. The interventions most commonly used were verbal management, patient isolation, and intramuscular medication. CONCLUSION: For the first time, the occurrence of violent and antisocial behavior was measured in a forensic psychiatric population.
精神病院住院病人的暴力和反社会行为后果严重,可能影响对施暴者的治疗。缺乏对这一现象的发生率及其特征的了解有助于使目前的情况长期存在。目的:提出关于该主题的最新文献综述,估计精神病院人群中暴力和反社会行为的发生率,并描述一种记录这一现象的系统方法的实施。方法:选取毛里西奥·卡多佐法医精神病学研究所(Instituto Psiquiatrico Forensic Mauricio Cardoso, IPFMC)住院精神病患者为研究对象。采用Yudofsky的外显攻击量表(OAS)和Tengstrom等人的随访问卷。在1年的随访期间,每天对暴力和反社会行为的发作进行评估,并记录在量表和问卷上。人口样本包括从IPFMC住院患者中随机抽取的68名男性患者。结果:在评估期间,暴力/反社会行为的发生率为200次,涉及50例患者。攻击和反社会行为主要发生在白天。最常用的干预措施是口头管理、患者隔离和肌肉注射药物。结论:首次在法医精神科人群中测量了暴力和反社会行为的发生情况。
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引用次数: 10
Trauma complexo e suas implicações diagnósticas 复杂创伤及其诊断意义
Pub Date : 2011-01-01 DOI: 10.1590/S0101-81082011000100010
Thiago Viola, Rodrigo Grassi-Oliveira, A. Renner, B. Schiavon
Prolonged exposure to multiple traumatic events of an interpersonal nature, particularly during development, has shown psychological consequences and symptoms not included among the current diagnostic criteria of post-traumatic stress disorder (PTSD). These negative and chronic situations during childhood and adolescence provide further evidence of the existence of a psychopathological syndrome associated with complex (dis)adaptations to a number of traumatic effects. The absence of a cohesive and reliable diagnosis for these patients negatively affects symptom identification and treatment planning. The aim of the present study was to review the definition of trauma, presenting the concept of complex trauma and investigating its clinical implications and the diagnostic categories deriving from this construct. Important questions are raised about differences between complex trauma and PTSD, followed by an investigation of PTSD symptoms and comorbid disorders, as well as the limitations of PTSD diagnosis. Taking into consideration the psychopathological impact associated with complex trauma, the article discusses the possibility of including a new diagnostic category in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders is discussed, as part of the spectrum of post-traumatic psychopathologies.
长期暴露于具有人际关系性质的多重创伤性事件,特别是在发育过程中,已经显示出心理后果和症状,这些后果和症状不包括在目前的创伤后应激障碍(PTSD)诊断标准中。这些儿童期和青春期的消极和慢性情况进一步证明,存在与对许多创伤影响的复杂(不)适应相关的精神病理综合征。缺乏一个连贯和可靠的诊断对这些患者的症状识别和治疗计划产生负面影响。本研究的目的是回顾创伤的定义,提出了复杂创伤的概念,并探讨其临床意义和诊断类别由此产生的概念。复杂创伤和创伤后应激障碍之间的差异提出了重要的问题,随后对创伤后应激障碍的症状和共病障碍的调查,以及创伤后应激障碍诊断的局限性。考虑到与复杂创伤相关的精神病理学影响,本文讨论了在《精神疾病诊断与统计手册》第5版中纳入新诊断类别的可能性,作为创伤后精神病理学谱系的一部分。
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引用次数: 10
Screening for signs and symptoms of autism spectrum disorders in siblings 筛查兄弟姐妹中自闭症谱系障碍的症状和体征
Pub Date : 2011-01-01 DOI: 10.1590/S0101-81082011000200009
T. Mecca, R. Bravo, Renata de Lima Velloso, J. S. Schwartzman, D. Brunoni, M. Teixeira
Pervasive developmental disorders (PDD) are characterized by comprehensive and qualitative abnormalities affecting three areas of development: reciprocal social interaction, communication, and a repetitive, stereotyped behavioral repertoire, of limited interests. Genetic studies have identified the recurrence of PDD in the same family. The present study aimed to trace the occurrence of signs and symptoms of PDD in the siblings of patients with this diagnosis. The study included 25 subjects from 19 families. Data collection was performed using the Brazilian version of the Autism Screening Questionnaire (ASQ). Two cases of PDD in siblings were confirmed (10.52% of cases): a monozygotic twin brother and the brother of a proband with a diagnosis of Asperger syndrome. Our data indicate higher rates of PDD in siblings than described in the literature (2-6%), close to the findings that suggest a 10% rate of familial recurrence in dizygotic twins. This result provides evidence of possible neurogenetic factors to explain the occurrence of PDD in relatives of the probands assessed and underscores the need to screen not only the child under evaluation, but also their siblings.
广泛性发育障碍(PDD)的特点是影响三个发展领域的全面和定性异常:互惠的社会互动,沟通和重复的,刻板的行为,有限的兴趣。遗传学研究已经确定PDD在同一家族中复发。本研究旨在追踪PDD患者的兄弟姐妹的体征和症状的发生。这项研究包括来自19个家庭的25名研究对象。使用巴西版自闭症筛查问卷(ASQ)进行数据收集。兄弟姐妹中确诊2例PDD(10.52%的病例):一个同卵双胞胎兄弟和一个诊断为阿斯伯格综合征的先证兄弟。我们的数据表明兄弟姐妹中PDD的发生率比文献中描述的要高(2-6%),接近于异卵双胞胎家族复发率为10%的发现。这一结果为可能的神经遗传因素提供了证据,解释了被评估先证者亲属中PDD的发生,并强调了不仅需要对被评估的儿童进行筛查,还需要对他们的兄弟姐妹进行筛查。
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引用次数: 1
Revista de Psiquiatria do Rio Grande do Sul: new trends 大南精神病学杂志:新趋势
Pub Date : 2011-01-01 DOI: 10.1590/S0101-81082011000200001
F. Kapczinski, Jair Segal, P. Magalhães, Rodrigo Grassi de Oliveira
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引用次数: 1
Group therapy for morbid jealousy 病态嫉妒的团体治疗
Pub Date : 2011-01-01 DOI: 10.1590/S0101-81082011000200011
D. Gulassa, Andrea Lorena da Costa, Eglacy C. Sophia, Cíntia Sanches, Talita Vendrame, M. Zilberman
2Psicologa, Pro-AMITI. Mestre em Ciencias, USP. 3 Psicologa, Pro-AMITI. Mestre e Doutoranda em Ciencias, USP. 4 Psicologa, Pro-AMITI.
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引用次数: 0
Reforma psiquiátrica e o Datasus: o uso de um instrumento ou o uso instrumental? 精神病学改革与数据:使用工具还是使用工具?
Pub Date : 2011-01-01 DOI: 10.1590/S0101-81082011000100012
Lucas Spanemberg
Psiquiatra. Preceptor de Residencia, Unidade de Internacao Psiquiatrica, Hospi-tal Sao Lucas, Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS. Doutorando, Programa de Pos-Graduacao em Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS.Suporte fi nanceiro: Bolsa de Doutorado, Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES).
心理医生。精神导师的住所,Internacao单元,Hospi -卢卡斯,但是南里奥格兰德河天主教大学(PUCRS),波尔图,RS,博士生,程序的工具-Graduacao医生,南里奥格兰德州联邦大学(UFRGS),波尔图,RS.Suportefi金融证券交易所:博士学位,协调人员改进的高(披肩)。
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引用次数: 1
期刊
Boletim Geografico do Rio Grande do Sul
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