Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):545-551
To assess the clinical characteristics of subjects with gender dysphoria (GD).
A cross-sectional study of adults with GD. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Sociodemographic data, clinical data and life habits were recorded.
Total of 44 subjects participated in the study: 36 (82%) trans women and 8 (18%) trans men. Forty-three (98%) of the GD patients had anxiety (36 [100%] trans women and 7 [87.5%] trans men), and 36 (82%) had depression (29 [80.5%] trans women and 7 [87.5%] trans men). Suicide had been attempted by 32 (73%) subjects. The rates of depression were lower among the subjects living with partners, parents, or other people than among those living alone (p = 0.03), and it was also lower among the subjects who were married compared to those who were dating or single (p = 0.03).
Improving the relationship status may reduce the prevalence of depressive symptoms in GD patients. There was a high rate of attempted suicide in this sample.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(11):531-537
To analyze the internal consistency and the construct validity of the State-Trait Anxiety Inventory (STAI) State-Anxiety (S-Anxiety) scale for pregnant women during labor.
A study of measurement property including 150 pregnant women aged between 15 and 45 years old, during the first period of labor and with term pregnancies. The questionnaire used was the STAI S-Anxiety scale. In order to assess the internal consistency, Cronbach’s α was calculated through an exploratory factor analysis. The correlation between the factors was calculated using the Pearson coefficient. The state of significance used for this analysis was 0.05.
The STAI S-Anxiety scale used in the context of labor showed two factors represented as the absence (factor 1) and the presence of anxiety (factor 2); item 4 (“I regret it”) did not show a representative value. Both factors showed high indications of Cronbach’s α, varying from 0.830 for factor 1, and 0.723 for factor 2. In the results of the Pearson coefficient between the two factors, a significant but weak correlation was observed (r = -0.188; p = 0.021).
The STAI S-Anxiety scale used in pregnant women during labor presented appropriate values of internal consistency; however, item 3 did not show a significant factorial value. Therefore, this questionnaire must be applied cautiously and carefully without the use of the item 4 in the clinical practice and in researches about labor.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(12):571-577
DOI 10.1590/S0100-720320150005419
To evaluate the nutritional and psychological factors associated with the occurrence of the practice of pica in pregnant women attending a public hospital in Rio de Janeiro, Brazil.
The study was based on a descriptive design with exploratory features, and conducted on 13 adult and adolescent pregnant women aged 16 to 40 years with a diagnosis of pica in the current pregnancy. Pica was diagnosed by a nutritionist in a standardized interview situation, when questions about the occurrence and frequency of pica, and types of substance ingestion were investigated. After signing the Informed Consent Form (ICF), all participants were evaluated by a nutritionist and seven of them were submitted to psychological assessment with standardized instruments to evaluate stress and anxiety, and to assess coping strategies.
The type of pica most frequently reported was pagophagia (30.8%) and the consumption of fruit with salt (30.8%). The most prevalent coping strategies were "religious practice-focused" and "seeking social support", both presented by 42% of the pregnant women. We observed the occurrence of some degree of stress and anxiety in all pregnant women, as well as comorbidities (69.2%) and gastrointestinal symptoms (84.6%).
Considering that pica may be associated with increased perinatal risk, it is very important to investigate this disorder during prenatal care, and to dopt obstetric, psychological and nutritional preventive practices to reduce the complications for mother and fetus.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(7):310-314
DOI 10.1590/SO100-720320140005008
The objective of this study was to investigate the relationship between overactive bladder syndrome and anxiety in older women.
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%.
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).
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.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(7):321-326
DOI 10.1590/S0100-72032010000700003
PURPOSE: to study the association between hypothyroidism and depression and anxiety symptoms. METHODS: a case-control study was carried out from July 2006 to March 2008 on 100 patients (50 patients with primary hypothyroidism and 50 euthyroid controls) aged 18 to 65 years. Age, race/skin color, marital status, education level, alcohol use, working status, body mass index and menopausal status were evaluated. TSH levels were determined and the Beck Depression and Beck Anxiety Scales were applied to all cases and controls. Statistical analysis was performed using the SPSS software version 14.0. The level of significance was set at p<0.05. RESULTS: there was no demographic or epidemiologic difference between groups. The concomitant presence of anxiety and depression was five times greater among cases than among controls (20.0 versus 4.0%, p=0.01). Anxiety symptoms were approximately three times more frequent among cases (40.0%) than among controls (14.0%) (p=0.003), while the prevalence of depressive symptoms was 75% higher among cases (28.0%) than among controls (16.0%), but this did not reach statistical significance (p=0.15). We found no association between TSH levels and the prevalence of anxiety or depression symptoms. CONCLUSIONS: this case-control study showed a greater probability for hypothyroid patients to develop anxiety and depression symptoms when compared to euthyroid controls. Due to the high prevalence of hypothyroidism and depression observed in clinical practice, depressive symptoms must be considered in patients with thyroid dysfunction and depressed patients should be tested for TSH.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(1):28-34
DOI 10.1590/S0100-72032009000100006
PURPOSE: to determine the prevalence of depression and anxiety in climacteric women and the probable factors responsible for its occurrence. METHODS: a transversal study that has selected 93 women attended at a climacteric outpatient clinic, from May 2006 to August 2007. Inclusion criteria were: women from 40 to 65 years old who agreed with participating in the project. Exclusion criteria: patients in hormonal therapy, hormone-therapy by implant, DIUs and depo injections in the preceding six months, endocrinopathies leading to menstrual irregularities, hepatopathies, thrombopathies, use of drugs which interfere in the menstrual cycle, anxiolytics and antidepressants (as their use indicates previous diagnosis of mood disorders), hysterectomy, oophorectomy, cancer or psychiatric disease, and patients who had been submitted to radio or chemotherapy. During the interview, four questionnaires were applied: Anamnesis, containing socio-demographic, clinical and living habits data; Blatt-Kupperman's Menopausal Index for climacteric syndrome diagnosis; Anxiety sub-scale of the Hospital Anxiety and Depression scale (HADS-A) for anxiety diagnosis; and Beck's Depression Inventory for the diagnosis of depression. Descriptive and correlation analysis among the variables, χ2 and Hosmer-Lemeshow tests were performed using the Statistica Software program, version 6. RESULTS: the average depression prevalence among the patients was 36.8%, while that of anxiety was 53.7%. There was no significant difference between the prevalence of depression and anxiety in the three phases of climacterium. There was a significant relationship between the presence of moderate climacteric symptoms and the presence of mood alterations (p<0.001). Depression was more frequent in women with anxiety (OR=4.2) and insomnia (OR=4.9), having a job being a protection factor (OR=0.2). Risk factors related to anxiety were the presence of depression (OR=6.1) and antecedents of pre-menstrual tension (OR=7.0). CONCLUSIONS: the prevalence of depression and anxiety is high in climacterium, being possible to detect risk factors related to their occurrence.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(6):358-364
DOI 10.1590/S0100-72032006000600007
PURPOSE: to assess the frequency of stress and anxiety levels in infertile women, in order to obtain data for specific psychological intervention. METHODS: a cross-sectional study involving 152 infertile (mean age 30.3±5.4 years), and 150 healthy control women (25.7±7.9 years). All patients were evaluated with the Lipp's Inventory of Stress Symptoms and the State-Trait Anxiety Inventory. Considered dependent variables were: stress frequency and anxiety scores (state and trait). Statistical analysis was performed by the chi2 and Mann-Whitney tests, and logistical regression to test associations between response variables and considered risk factors. Statistical significance was defined as p<0.05. RESULTS: the stress was more frequent in the infertile group than in the control group (61.8 and 36.0%, respectively); however, no significant differences were observed between groups in relation to stress phases and predominant symptoms. With respect to anxiety, there were no significant differences between infertile and control groups as to median state scores (39.5 and 41.0, respectively) and anxiety trait scores (44.0 and 42.0, respectively). Factors significantly associated with greater risk for high anxiety scores in the infertile group were: unawareness of the causal factor, diagnostic phase investigation, and lack of children from other marriages. CONCLUSIONS: it can be concluded that infertile women are more vulnerable to stress; however, they are capable of adapting themselves to stressful events without serious physical or psychological compromise.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(3):171-178
DOI 10.1590/S0100-72032006000300006
PURPOSE: postpartum anxiety (PPA) is highly prevalent and has important consequences on mother and newborn. The aim of the present study was to estimate the prevalence of PPA and its risk factors, in a sample of women attending a private setting. METHODS: a cross-sectional study was performed with 299 women, at a routine gynecological visit, from August 2000 to May 2003. The Spielberger State-Trait Anxiety Inventory (STAIT) and a questionnaire with sociodemographic data and obstetric data were used. Inclusion criteria were: women with no past or present history of depression, psychiatric treatment, alcohol or drug abuse and whose children were alive. The prevalences of PPA-trace and PPA-state, that evaluate characteristics of personality and transitory anxiety, respectively, were estimated with 95% confiance intervals (CI). Odds ratios and 95% CI were used to examine the association between PPA and exposure variables. Hypothesis testing was done by the chi2 test or chi2 test for linear trend, when categories were ordered. A p value < 0.05 was considered to be statistically significant. RESULTS: the prevalences of PPA-state and PPA-trace were 44.8% (CI 95%: 39.1 - 50.7) and 46.1% (CI 95%: 40.4 - 52.0, respectively). Formal agreement between scales was moderate (kappa = 0.55; p<0.001). By univariate analysis, lower mother income and presence of newborn complications were associated with PPA-state and PPA-trace. Lower maternal age and greater number of alive children were associated with PPA-trace and PPA-state, respectively. By multivariate analysis, PPA-trace and PPA-state were associated with higher mother income (OR:0.39; IC 95%: 0.21 - 0.74, p=0,005; OR:0.46; IC 95%: 0.24 - 0.87, p=0.02) and presence of complications in newborns (OR:2.15; IC 95%: 1.02 - 4.54, p=0.04) (OR:2.47; IC 95%: 1.16 - 5.25, p=0.02), respectively. PPA-trace was associated with greater maternal age (OR:0.34; IC 95%: 0.13 - 0.88, p=0.008), while PPA-state was associated with greater number of alive children (OR:1.82; IC 95%: 1.01 - 3.29, p=0.04). CONCLUSIONS: PPA was highly prevalent in this sample of women attending a private setting. Higher mother income and greater maternal age decrease the risk of AP, while presence of complications in newborns and greater number of alive children increase the risk.