Depression Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(9):252-257
DOI 10.1590/S0100-72032011000900006
PURPOSE: To describe and compare the phases of stress of primiparae in the third trimester of pregnancy and postpartum, associating them with the occurrence of postpartum depression. METHODS: The study consisted of two stages (Stage 1 and Stage 2), characterized as longitudinal research. Ninety-eight primiparae participated in Stage 1, and 64 of them participated in Stage 2. In Stage 1, data were collected in the third trimester of pregnancy, and in Stage 2, at least 45 days after delivery. The Stress Symptoms Inventory Lipp (ISSL) was applied in Stage 1 and an interview was held to characterize the sample. In Stage 2, we applied again the ISSL and also the EPDS (Edinburgh Postnatal Depression Scale). Data were analyzed using SPSS for Windows®, version 17.0. The statistical analyses were performed using the Student’s t-test and the Spearman p. RESULTS: Seventy-eight percent of the participants showed significant signs of stress in the third quarter and 63% of them during the postpartum period, with a significant difference in the stress occurring in the third trimester and postpartum (t=2.20, p=0.03). There was also a correlation between the stress occurring during pregnancy and in the puerperium and the manifestation of postpartum depression (p<0.001). CONCLUSION: More than half of the women experience significant stress signs during both pregnancy and the postpartum period. However, the frequency of onset of significant symptoms of stress was higher during pregnancy than during the puerperium. These results seem to be closely related to the manifestation of postpartum depression, indicating the relationship between stress and postpartum depression.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(9):252-257
DOI 10.1590/S0100-72032011000900006
PURPOSE: To describe and compare the phases of stress of primiparae in the third trimester of pregnancy and postpartum, associating them with the occurrence of postpartum depression. METHODS: The study consisted of two stages (Stage 1 and Stage 2), characterized as longitudinal research. Ninety-eight primiparae participated in Stage 1, and 64 of them participated in Stage 2. In Stage 1, data were collected in the third trimester of pregnancy, and in Stage 2, at least 45 days after delivery. The Stress Symptoms Inventory Lipp (ISSL) was applied in Stage 1 and an interview was held to characterize the sample. In Stage 2, we applied again the ISSL and also the EPDS (Edinburgh Postnatal Depression Scale). Data were analyzed using SPSS for Windows®, version 17.0. The statistical analyses were performed using the Student’s t-test and the Spearman p. RESULTS: Seventy-eight percent of the participants showed significant signs of stress in the third quarter and 63% of them during the postpartum period, with a significant difference in the stress occurring in the third trimester and postpartum (t=2.20, p=0.03). There was also a correlation between the stress occurring during pregnancy and in the puerperium and the manifestation of postpartum depression (p<0.001). CONCLUSION: More than half of the women experience significant stress signs during both pregnancy and the postpartum period. However, the frequency of onset of significant symptoms of stress was higher during pregnancy than during the puerperium. These results seem to be closely related to the manifestation of postpartum depression, indicating the relationship between stress and postpartum depression.
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. 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. 2010;32(5):247-253
DOI 10.1590/S0100-72032010000500008
PURPOSE: to compare the quality of life (QL) of women with and without chronic pelvic pain (CPP) and to investigate the factors associated with QL in women with CPP. METHODS: a cross-sectional study was conducted on 30 women with CPP and 20 women without CPP. Sociodemographic and clinical characteristics were evaluated. QL was investigated by applying the SF-36 questionnaire, which contains eight domains: functional capacity, physical aspects, pain, general health status, vitality, social aspects, emotional aspects, and mental health. These domains can be summarized into two groups: physical component summary (PCS) and mental component summary (MCS). Pain intensity was investigated by applying the visual analogue scale. Linear regression analysis was used to compare QL scores between women with and without CPP and to identify factors associated with the QL of women with CPP. RESULTS: the mean age of women with and without CPP was 35.2±7.5 and 36±9.3 years (p=0.77), respectively. Women with CPP had a lower monthly family income (p=0.04) and a higher prevalence of dysmenorrhea (87 versus 40%; p<0.01) and depression (30 versus 5%; p=0.04) compared to women without CPP. Adjusted analysis for potential confounding variables revealed that women with CPP had lower QL scores in the pain (p<0.01) and social aspects (p<0.01) domains. Depression was negatively associated with the emotional aspects domain (p=0.05) and with the MCS (p=0.03), while pain intensity was negatively related to the pain domain (p<0.01) of the QL of women with CPP. CONCLUSIONS: women with CPP presented a worse QL compared to women without CPP. Depression and pain intensity were negatively related to the QL of women with CPP. Thus, the evaluation and treatment of pain and depressive symptoms must be among the priorities that aim to improve the QL of women with CPP.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(5):247-253
DOI 10.1590/S0100-72032010000500008
PURPOSE: to compare the quality of life (QL) of women with and without chronic pelvic pain (CPP) and to investigate the factors associated with QL in women with CPP. METHODS: a cross-sectional study was conducted on 30 women with CPP and 20 women without CPP. Sociodemographic and clinical characteristics were evaluated. QL was investigated by applying the SF-36 questionnaire, which contains eight domains: functional capacity, physical aspects, pain, general health status, vitality, social aspects, emotional aspects, and mental health. These domains can be summarized into two groups: physical component summary (PCS) and mental component summary (MCS). Pain intensity was investigated by applying the visual analogue scale. Linear regression analysis was used to compare QL scores between women with and without CPP and to identify factors associated with the QL of women with CPP. RESULTS: the mean age of women with and without CPP was 35.2±7.5 and 36±9.3 years (p=0.77), respectively. Women with CPP had a lower monthly family income (p=0.04) and a higher prevalence of dysmenorrhea (87 versus 40%; p<0.01) and depression (30 versus 5%; p=0.04) compared to women without CPP. Adjusted analysis for potential confounding variables revealed that women with CPP had lower QL scores in the pain (p<0.01) and social aspects (p<0.01) domains. Depression was negatively associated with the emotional aspects domain (p=0.05) and with the MCS (p=0.03), while pain intensity was negatively related to the pain domain (p<0.01) of the QL of women with CPP. CONCLUSIONS: women with CPP presented a worse QL compared to women without CPP. Depression and pain intensity were negatively related to the QL of women with CPP. Thus, the evaluation and treatment of pain and depressive symptoms must be among the priorities that aim to improve the QL of women with CPP.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):433-439
DOI 10.1590/S0100-72032009000900003
PURPOSE: the main goal of this study is to evaluate the emotional conditions among mothers of newborns with visible malformation (Group M) and mothers of eutrophic newborns (Group E) soon after birth. METHODS: twenty-two mothers from the Group M were matched by age and number of children to 22 mothers of the Group E. They were assessed through the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). The data were complemented by interviews and analyses of the medical files of both mother and child. RESULTS: the results have shown significant differences in the mean scores of the three subscales (trait anxiety, state anxiety, dysphoria/depression) between the two groups of mothers. In terms of clinical signs, there were a significantly larger percentage of mothers from Group M identified with depression and anxiety after the child's birth, and for both conditions when compared with mothers from Group E. Although the results may reflect characteristics of the maternal personality, the trait anxiety was significantly more evident in mothers of malformed children, especially due to the child's health condition, its referral to the ICU and his/her condition regarding their future life. CONCLUSION: the percentage of mothers with clinical depression and anxiety suggests the need for either individual or group support to attend the needs of the mothers and mitigate the adverse effects of stressors throughout the child's development. Support should also be provided during pregnancy, when the mothers currently receive the news about the malformation.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(9):433-439
DOI 10.1590/S0100-72032009000900003
PURPOSE: the main goal of this study is to evaluate the emotional conditions among mothers of newborns with visible malformation (Group M) and mothers of eutrophic newborns (Group E) soon after birth. METHODS: twenty-two mothers from the Group M were matched by age and number of children to 22 mothers of the Group E. They were assessed through the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). The data were complemented by interviews and analyses of the medical files of both mother and child. RESULTS: the results have shown significant differences in the mean scores of the three subscales (trait anxiety, state anxiety, dysphoria/depression) between the two groups of mothers. In terms of clinical signs, there were a significantly larger percentage of mothers from Group M identified with depression and anxiety after the child's birth, and for both conditions when compared with mothers from Group E. Although the results may reflect characteristics of the maternal personality, the trait anxiety was significantly more evident in mothers of malformed children, especially due to the child's health condition, its referral to the ICU and his/her condition regarding their future life. CONCLUSION: the percentage of mothers with clinical depression and anxiety suggests the need for either individual or group support to attend the needs of the mothers and mitigate the adverse effects of stressors throughout the child's development. Support should also be provided during pregnancy, when the mothers currently receive the news about the malformation.
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. 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(2):91-100
DOI 10.1590/S0100-72032006000200004
PURPOSE: to evaluate the efficacy of the use of isoflavones in the treatment of depressive symptoms in climacteric women. METHODS: placebo-controlled, randomized double-blind experimental study with 84 climacteric women who were assisted at the Lauro Wanderley University Hospital Ambulatory, in João Pessoa, Paraíba, Brazil. In the evaluation of the depressive symptoms the Self-evaluation questionnare of Hamilton's rating scale for depresion (QAEH-D) was used in the pretreatment visit (VT1), and in the 8th (VT2) and 16th (VT3) week after treatment. The experimental group (GExp) received soy extract with isoflavones, 120 mg per day, and the control group (GCont), placebo. The comparison of the scores of the QAEH-D between the VT1, VT2 and VT3 groups constituted the primary measure of efficacy (t test, p<0.05). Secondary analysis included the estimate of the "domino hypothesis" and the clinical and laboratory evaluation of side effects. RESULTS: there was a significant reduction of the QAEH-D scores in the GExp (VT2
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(2):91-100
DOI 10.1590/S0100-72032006000200004
PURPOSE: to evaluate the efficacy of the use of isoflavones in the treatment of depressive symptoms in climacteric women. METHODS: placebo-controlled, randomized double-blind experimental study with 84 climacteric women who were assisted at the Lauro Wanderley University Hospital Ambulatory, in João Pessoa, Paraíba, Brazil. In the evaluation of the depressive symptoms the Self-evaluation questionnare of Hamilton's rating scale for depresion (QAEH-D) was used in the pretreatment visit (VT1), and in the 8th (VT2) and 16th (VT3) week after treatment. The experimental group (GExp) received soy extract with isoflavones, 120 mg per day, and the control group (GCont), placebo. The comparison of the scores of the QAEH-D between the VT1, VT2 and VT3 groups constituted the primary measure of efficacy (t test, p<0.05). Secondary analysis included the estimate of the "domino hypothesis" and the clinical and laboratory evaluation of side effects. RESULTS: there was a significant reduction of the QAEH-D scores in the GExp (VT2
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):737-743
DOI 10.1590/S0100-72032005001200006
PURPOSE: to evaluate the frequency of anxiety and depression in main caretakers of patients with terminal breast or gynecological cancer. METHODS: for this cross-sectional study, 133 informal caretakers of terminally-ill breast and gynecologic cancer patients were included. Patients were hospitalized for palliative care in the Oncology Clinic of the "Centro de Atenção Integral à Saúde da Mulher (Campinas, Brasil) from August 2002 to May 2004. Seventy-one of the patients had breast cancer and 62 had gynecological malignancies. Hospital Anxiety and Depression Scale (HAD) was applied to these informal caretakers, in order to detect anxiety and depression, and they were also interviewed to provide additional information regarding their age, gender, religion, relation to patient, current occupation, if they cared for other people, whether their routine had changed and whether other people helped them to care for the patient. Logistic regression was used to calculate the odds ratio (OR) and its confidence interval (CI), used to assess the relationship between the diagnoses of anxiety and depression among the informal caretakers. For multiple analyses, the stepwise criterion for variable selection was used. RESULTS: 43% percent of the patients identified their daughters as their main caretaker, and 24%, their husbands. Most of the caretakers were over 35 years old (63%), 68% were female, 59% were unemployed, 47% cared for another person and 84% referred that his/her routine had changed because of caring. Anxiety was detected in 99 caretakers (74.4%) and depression in 71 (53.4%). Anxiety and depression were strongly correlated (odds ratio 5.6; 95% confidence interval 2.2 to 15.9). Bivariate analysis disclosed that the patients' husbands were less affected by depression, but multivariate analysis revealed that only the fact of being male was related to a lower prevalence of anxiety. CONCLUSION: caring for terminally-ill cancer patients led to high prevalence of anxiety and depression. Only men and the patients' husbands were found to have a lower prevalence of anxiety.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):737-743
DOI 10.1590/S0100-72032005001200006
PURPOSE: to evaluate the frequency of anxiety and depression in main caretakers of patients with terminal breast or gynecological cancer. METHODS: for this cross-sectional study, 133 informal caretakers of terminally-ill breast and gynecologic cancer patients were included. Patients were hospitalized for palliative care in the Oncology Clinic of the "Centro de Atenção Integral à Saúde da Mulher (Campinas, Brasil) from August 2002 to May 2004. Seventy-one of the patients had breast cancer and 62 had gynecological malignancies. Hospital Anxiety and Depression Scale (HAD) was applied to these informal caretakers, in order to detect anxiety and depression, and they were also interviewed to provide additional information regarding their age, gender, religion, relation to patient, current occupation, if they cared for other people, whether their routine had changed and whether other people helped them to care for the patient. Logistic regression was used to calculate the odds ratio (OR) and its confidence interval (CI), used to assess the relationship between the diagnoses of anxiety and depression among the informal caretakers. For multiple analyses, the stepwise criterion for variable selection was used. RESULTS: 43% percent of the patients identified their daughters as their main caretaker, and 24%, their husbands. Most of the caretakers were over 35 years old (63%), 68% were female, 59% were unemployed, 47% cared for another person and 84% referred that his/her routine had changed because of caring. Anxiety was detected in 99 caretakers (74.4%) and depression in 71 (53.4%). Anxiety and depression were strongly correlated (odds ratio 5.6; 95% confidence interval 2.2 to 15.9). Bivariate analysis disclosed that the patients' husbands were less affected by depression, but multivariate analysis revealed that only the fact of being male was related to a lower prevalence of anxiety. CONCLUSION: caring for terminally-ill cancer patients led to high prevalence of anxiety and depression. Only men and the patients' husbands were found to have a lower prevalence of anxiety.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(6):347-351
DOI 10.1590/S0100-72032000000600005
Purpose: to analyze the symptoms of premenstrual syndrome (PMS), its duration, time of presentation and pathogenesis. Methods: a questionnaire was applied to 254 women aged 20 to 44 years, without gynecological or clinical conditions affecting their general state or physical well-being, excluding those with amenorreha for more than six months, hysterectomized or pregnant. Results: one hundred and ten women (43.3%) describing at least one intense symptom causing harm to their life, were considered as having PMS. Irritability was presented by 86.4%, tiredness by 70.9%, depression by 61.8%, headache by 61.8%, breast tenderness by 59.1% and abdominal pain by 54.5%. Almost all (94.5%) had more that one symptom, 89.1% presented psychological complaints, and 76.4% associated physical and psychological complaints. Most declared that duration of the symptoms was three to four days (32.4%) or five to seven days (31.4%). Conclusions: the clinical picture of PMS is generally composed of irritability and/or depression, associated with tiredness and headache or breast pain, there being association of physical and psychological symptoms, for 3 to 7 days, and it is difficult to attribute a single etiology to it at this stage of knowledge.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(6):347-351
DOI 10.1590/S0100-72032000000600005
Purpose: to analyze the symptoms of premenstrual syndrome (PMS), its duration, time of presentation and pathogenesis. Methods: a questionnaire was applied to 254 women aged 20 to 44 years, without gynecological or clinical conditions affecting their general state or physical well-being, excluding those with amenorreha for more than six months, hysterectomized or pregnant. Results: one hundred and ten women (43.3%) describing at least one intense symptom causing harm to their life, were considered as having PMS. Irritability was presented by 86.4%, tiredness by 70.9%, depression by 61.8%, headache by 61.8%, breast tenderness by 59.1% and abdominal pain by 54.5%. Almost all (94.5%) had more that one symptom, 89.1% presented psychological complaints, and 76.4% associated physical and psychological complaints. Most declared that duration of the symptoms was three to four days (32.4%) or five to seven days (31.4%). Conclusions: the clinical picture of PMS is generally composed of irritability and/or depression, associated with tiredness and headache or breast pain, there being association of physical and psychological symptoms, for 3 to 7 days, and it is difficult to attribute a single etiology to it at this stage of knowledge.