1
|
Grolli RE, Bertollo AG, Behenck JP, de Araujo Borba L, Plissari ME, Soares SJB, Manica A, da Silva Joaquim L, Petronilho F, Quevedo J, Bagatini MD, Réus GZ, Ignácio ZM. Quetiapine effect on depressive-like behaviors, oxidative balance, and inflammation in serum of rats submitted to chronic stress. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2023:10.1007/s00210-023-02406-8. [PMID: 36735044 DOI: 10.1007/s00210-023-02406-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/23/2023] [Indexed: 02/04/2023]
Abstract
Major depressive disorder (MDD) etiology is still not completely understood, and many individuals resist the traditional treatments. Chronic exposure to stressful events can contribute to development and progression and be involved in biological changes underlying MDD. Among the biological mechanisms involved, inflammatory changes and oxidative balance are associated with MDD pathophysiology. Quetiapine, a second-generation antipsychotic, induces a better therapeutic response in individuals refractory to traditional treatments. The main objectives of this research were as follows: to evaluate the effect of chronic mild stress (CMS) on depressive-like behaviors, oxidative stress, and inflammation in adult rats; to evaluate the possible antidepressant, antioxidant, and anti-inflammatory effects of quetiapine. The animals were submitted to CMS protocols. At the end of the CMS, the animals were submitted to a chronic treatment for 14 days with the following drugs: quetiapine (20 mg/kg), imipramine (30 mg/kg), and escitalopram (10 mg/kg). At the end of the treatments, the animals were evaluated in the open field tests, anhedonia (splash test), and forced swimming. The animals were euthanized after the behavioral tests, and serum samples were collected. Myeloperoxidase (MPO) activity and interleukin-6 (IL-6) levels were analyzed. CMS induced an increase in depressive-like behaviors, and quetiapine significantly reduced these behaviors. MPO activity and IL-6 levels increased in the serum of animals submitted to CMS. Quetiapine significantly reduced MPO activity and IL-6 levels. These results corroborate other evidence, indicating that chronic stress is a relevant phenomenon in the etiology of depression and suggesting that quetiapine induces an antidepressant effect because it reduces oxidative and inflammatory mechanisms.
Collapse
Affiliation(s)
- Roberta Eduarda Grolli
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, 89815-899, Brazil
| | - Amanda Gollo Bertollo
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, 89815-899, Brazil
| | - João Paulo Behenck
- Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciuma, SC, Brazil
| | - Laura de Araujo Borba
- Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciuma, SC, Brazil
| | - Marcos Eduardo Plissari
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, 89815-899, Brazil
| | - Silvio José Batista Soares
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, 89815-899, Brazil
| | - Aline Manica
- Graduate Program in Health Sciences - Community University of the Chapecó Region, Chapecó, SC, Brazil
| | - Larissa da Silva Joaquim
- Neurobiology of Metabolic and Inflammatory Processes Laboratory, Graduate Program in Health Sciences, University of South Santa Catarina, Tubarão, SC, Brazil
| | - Fabricia Petronilho
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciuma, SC, Brazil
| | - João Quevedo
- Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciuma, SC, Brazil.,Center of Excellence On Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Neuroscience Graduate Program, Graduate School of Biomedical Sciences, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Margarete Dulce Bagatini
- Laboratory of Cell Culture, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Gislaine Zilli Réus
- Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciuma, SC, Brazil
| | - Zuleide Maria Ignácio
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, 89815-899, Brazil.
| |
Collapse
|
2
|
Galletta MAK, Oliveira AMDSS, Albertini JGL, Benute GG, Peres SV, Brizot MDL, Francisco RPV. Postpartum depressive symptoms of Brazilian women during the COVID-19 pandemic measured by the Edinburgh Postnatal Depression Scale. J Affect Disord 2022; 296:577-586. [PMID: 34606803 PMCID: PMC8485706 DOI: 10.1016/j.jad.2021.09.091] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/11/2021] [Accepted: 09/26/2021] [Indexed: 12/05/2022]
Abstract
BACKGROUND The COVID-19 pandemic gave rise to concerns about its potential impact on the mental health of pregnant and postpartum women as the general postpartum depression rates increased. METHODS Three postpartum questionnaires (Edinburgh Postnatal Depression Scale - EPDS; Anxiety and Depression Scale - HAD; and a demographic questionnaire about isolation and information acquisition) were used to evaluate the mental health of women with and without COVID-19 and determine the factors associated with depressive symptoms (EPDS ≥ 12). RESULTS Data from 184 participants with a mean of 56 postpartum days were analyzed. The rate of symptoms compatible with postpartum depression (PPD) was 38.8%, with a 14.3% positive response to item 10 on the EPDS (suicidal ideation - SI). Listening to the news about COVID-19 averaged 4.45 hours a day. Factors related to PPD were concerns about lack of hospital beds (OR = 2.45), absence of a partner (OR = 2.70), and anxiety symptoms (OR = 10). Factors related to SI were anxiety symptoms (OR = 1.56) and friends as a source of information (OR = 5.60). LIMITATIONS Considering the rapidly changing epidemiological conditions of this pandemic, this study may only be the photograph of an instant. CONCLUSIONS Higher rates of PPD in the Brazilian population are related not only to anxiety but also to an inadequate family environment, kind of information acquisition and concerns about the lack of hospital beds.
Collapse
Affiliation(s)
- Marco Aurélio Knippel Galletta
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
| | | | - Jéssica Gorrão Lopes Albertini
- Post graduation of the Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Gláucia Guerra Benute
- Post graduation of the Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Stela Verzinhasse Peres
- Fundação Faculdade de Medicina, Information and Epidemiology Section of the Oncocentro de São Paulo Foundation, Brazil
| | - Maria de Lourdes Brizot
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Rossana Pulcineli Vieira Francisco
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | | |
Collapse
|
3
|
Pedraza DF, Lins ACDL. [Clinical complications during pregnancy: a systematic review of studies with pregnant Brazilian women]. CIENCIA & SAUDE COLETIVA 2021; 26:5329-5350. [PMID: 34787223 DOI: 10.1590/1413-812320212611.3.33202019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 11/21/2019] [Indexed: 11/22/2022] Open
Abstract
The scope of this paper was to describe the main clinical complications among pregnant Brazilian women reported in the literature, identifying the most relevant exposure factors and their outcomes in maternal and child health. This is a systematic review of articles published between 2010 and 2018. Three reviews and 36 empirical articles were included; mental disorders (n=9), infectious diseases (n=9) and severe maternal morbidity (n=8) were the main clinical complications during pregnancy. In addition, four articles focused on determining the main conditions or causes of hospitalization, with a higher frequency of Urinary Tract Infection, anemia and hypertensive diseases. Maternal age at reproductive extremes, lower schooling, socioeconomic vulnerability, racial characteristics and the use of public health services were the most relevant exposure factors. Unfavorable health outcomes associated with clinical complications in pregnancy were verified in the eight articles with this profile. The frequency of pregnant women with potential life-threatening clinical complications is high in the country, highlighting the importance of primary care coverage and the implementation of interventions to reduce and prevent adverse maternal and child outcomes.
Collapse
Affiliation(s)
- Dixis Figueroa Pedraza
- Universidade Estadual da Paraíba. Av. das Baraúnas 351, Campus Universitário, Bodocongó. 58109-753 Campina Grande PB Brasil.
| | - Anahi Cézar de Lima Lins
- Universidade Estadual da Paraíba. Av. das Baraúnas 351, Campus Universitário, Bodocongó. 58109-753 Campina Grande PB Brasil.
| |
Collapse
|
4
|
Vanderkruik R, Gonsalves L, Kapustianyk G, Allen T, Say L. Mental health of adolescents associated with sexual and reproductive outcomes: a systematic review. Bull World Health Organ 2021; 99:359-373K. [PMID: 33958824 PMCID: PMC8061667 DOI: 10.2471/blt.20.254144] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 12/03/2020] [Accepted: 12/06/2020] [Indexed: 11/27/2022] Open
Abstract
Objective To systematically review the literature on the mental health of adolescents associated with sexual and reproductive outcomes, and compare the mental health outcomes with that of other age groups. Methods We searched seven databases for relevant peer-reviewed articles published between 1 January 2010 and 25 April 2019. Our inclusion criteria required that the study included age-disaggregated data on adolescents, and focused and assessed mental health outcomes associated with pregnancy or sexually transmitted infections. We extracted data on the specific health event, the mental health outcome and the method of measuring this, and comparisons with other age groups. Findings After initially screening 10 818 articles by title and abstract, we included 96 articles in our review. We observed that a wide-ranging prevalence of mental ill-health has been reported for adolescents. However, most studies of mental health during pregnancy did not identify an increased risk of depression or other mental disorders among adolescents compared with other age groups. In contrast, the majority of studies conducted during the postpartum period identified an increased risk of depression in adolescents compared with other age groups. Three studies reported on mental health outcomes following abortion, with varying results. We found no studies of the effect of sexually transmitted infections on mental health among adolescents. Conclusion We recommend that sexual and reproductive health services should be accessible to adolescents to address their needs and help to prevent any adverse mental health outcomes.
Collapse
Affiliation(s)
- Rachel Vanderkruik
- Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, United States of America
| | - Lianne Gonsalves
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Tomas Allen
- Department of Quality, Norms and Standards, World Health Organization, Geneva, Switzerland
| | - Lale Say
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| |
Collapse
|
5
|
Efeitos da auriculoterapia na ansiedade de gestantes no pré-natal de baixo risco. ACTA PAUL ENFERM 2020. [DOI: 10.37689/acta-ape/2020ao0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
6
|
Costa DO, Souza FISD, Pedroso GC, Strufaldi MWL. Mental disorders in pregnancy and newborn conditions: longitudinal study with pregnant women attended in primary care. CIENCIA & SAUDE COLETIVA 2018. [PMID: 29538550 DOI: 10.1590/1413-81232018233.27772015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to determine the presence and association of possible mental disorders diagnoses in primary care pregnant women and newborns' conditions. This is a longitudinal study with pregnant women (18-39 years), in the second and third trimesters of pregnancy, attended at primary care facilities in the metropolitan region of São Paulo (February to August/2014). The following tools were used: sociodemographic questionnaire; Mental Disorders in Primary Care Assessment tool; and an interview with information and mother´s perception of the behavior of newborns. Of the 300 pregnant women interviewed, 76 had possible diagnosis of mental disorders, 46 women had depression/dysthymia and 58 anxiety/panic symptoms. Low birth weight and prematurity was observed in 14 and 19 newborns, respectively, and there was no association with the probable diagnosis of mental disorders; the possible presence of mental disorders was associated with the mother's perception of newborns behavior. Pregnant women attended at low risk prenatal care showed relevant frequency of mental disorders; thus, the identification of these changes during pregnancy can also contribute to a better understanding of the mother-and-child dynamics and in the quality of family care.
Collapse
Affiliation(s)
- Daisy Oliveira Costa
- Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo. R. Botucatu 598, Vila Clementino. 04023-062 São Paulo SP Brasil.
| | - Fabíola Isabel Suano de Souza
- Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo. R. Botucatu 598, Vila Clementino. 04023-062 São Paulo SP Brasil.
| | - Glaura César Pedroso
- Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo. R. Botucatu 598, Vila Clementino. 04023-062 São Paulo SP Brasil.
| | - Maria Wany Louzada Strufaldi
- Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo. R. Botucatu 598, Vila Clementino. 04023-062 São Paulo SP Brasil.
| |
Collapse
|
7
|
Silva MT, Caicedo Roa M, Martins SS, da Silva ATC, Galvao TF. Generalized anxiety disorder and associated factors in adults in the Amazon, Brazil: A population-based study. J Affect Disord 2018; 236:180-186. [PMID: 29747135 DOI: 10.1016/j.jad.2018.04.079] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/06/2018] [Accepted: 04/14/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND The purpose of this study was to assess the prevalence and associated factors of generalized anxiety disorder (GAD) in adults using the seven-item GAD scale (GAD-7) and to evaluate the properties of the two-item (GAD-2) as a population screening tool. METHODS We carried out a cross-sectional population-based study in the Manaus Metropolitan Region in 2015, Brazil. Adults aged 18 years or more were eligible to participate. We performed probabilistic three-phase sampling and collected sociodemographic and clinical variables. Descriptive statistics and a Poisson regression with robust variance with corrections for complex sampling were used. The accuracy of GAD-2 was assessed using GAD-7 as the gold standard. RESULTS We included 4001 participants. The prevalence of GAD was 8.4% (95% confidence interval 7.6-9.4%) and was significantly associated with self-reported poor health status and presenting depressive symptoms (p < 0.01). GAD-2 sensitivity was 63.9%, and its specificity was 97.4%. LIMITATIONS Because of the cross-sectional design of the study, the results are prone to reverse causality and recall bias. The surveyed people were not questioned about their medical diagnosis of anxiety, access to mental health services, or alcohol, tobacco or other drug use. The screening tools were not validated in the Brazilian or Amazon population. CONCLUSION About eight in 100 adults living in Manaus presented GAD, and it is more prevalent among people with a poorer health status and depression. Because of its low sensitivity, GAD-2 is not useful as a screening tool.
Collapse
Affiliation(s)
- Marcus T Silva
- Faculty of Medicine, Federal University of Amazonas, Rua Afonso Pena, 1053, Manaus, Amazonas 69020-160, Brazil.
| | - Mónica Caicedo Roa
- Postgraduate Program of Collective Health, Faculty of Medicinal Sciences, State University of Campinas, Rua Tessália Vieira de Camargo, 126, Campinas, São Paulo 13083-887, Brazil
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, Room 509, New York, NY 10032, USA
| | - Andréa Tenório Correia da Silva
- Santa Marcelina Faculty of Medicine, Rua São João das Duas Barras, 95, Vila Carmosina, São Paulo, São Paulo 08270-080, Brazil; Department of Preventive Medicine, University of São Paulo, Av. Dr. Arnaldo, 455 Room 2218, Cerqueira César, São Paulo, São Paulo 01246-903, Brazil
| | - Tais F Galvao
- Faculty of Pharmaceutical Sciences, State University of Campinas, Campinas, Rua Candido Portinari, 200, Campinas, São Paulo 13083-871, Brazil
| |
Collapse
|
8
|
Serum n-3 polyunsaturated fatty acids are inversely associated with longitudinal changes in depressive symptoms during pregnancy. Epidemiol Psychiatr Sci 2017; 26:157-168. [PMID: 27026507 PMCID: PMC6998689 DOI: 10.1017/s204579601500116x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUNDS N-3 polyunsaturated fatty acids (PUFAs) have been hypothesised to be protective for depression during pregnancy. However, there are few data and no consensus regarding this association. In this line, we aim to evaluate if the concentration of n-3 and n-6 PUFAs, and their ratio, are associated with depressive symptoms throughout pregnancy. METHOD A prospective cohort of 172 Brazilian women was followed at 5-13th, 20-26th and 30-36th weeks of gestation. The presence of depressive symptoms was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) at each pregnancy trimester. Depression was defined as an EPDS score ≥11. The concentrations of n-3 [α-linolenic acid; eicosapentaenoic acid (EPA); docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA)] and n-6 PUFAs [linoleic acid; γ linolenic acid; eicosadienoic acid; eicosatrienoic acid; arachidonic acid; docosatetraenoic acid and docosapentaenoic acid] were expressed as absolute (μg/ml) values. The total n-6/n-3 ratio was calculated. Statistical analyses were performed using univariate and adjusted random intercept logistic model for each fatty acid (FA) considering the longitudinal nature of data. Covariates were selected as potential confounders based on their biological plausibility of having an association with the concentration of FA and depressive symptoms during pregnancy. RESULTS The prevalence of depressive symptoms was high in all pregnancy trimesters (1st = 33.7%; 2nd = 18.9%; 3rd = 17.4%). We did not find differences in means FA concentrations by depressive symptom classification, for each follow-up visit. The women presented a 5% decrease in the odds of having depressive symptoms for each one-week increase in the gestational age. As individual women progressed through pregnancy, higher concentrations of EPA (odds ratio (OR) = 0.92; 95% CI: 0.86-0.99), DHA (OR = 0.96; 95% CI: 0.93-0.99), DPA (OR = 0.87; 95% CI: 0.77-0.99) and total n-3 (OR = 0.98; 95% CI: 0.96-0.99) were associated with a lower odds of depressive symptoms, while higher total n-6/n-3 ratio were associated with greater odds of depressive symptoms (OR = 1.40; 95% CI: 1.09-1.79). We detected a decrease in the probability of depressive symptoms as concentrations of total n-3 FA, α-linolenic acid, DPA, and DHA increased. We also observed a sharper decline for women with initial greater chance of depressive symptoms compared with those with lower chance of having these symptoms. CONCLUSIONS We found a high prevalence of depressive symptoms in low-income Brazilian pregnant women and no significant associations between n-6 FA and depressive symptoms. Lower serum concentrations of DHA, EPA and DPA and a higher n-6/n-3 ratio at each pregnancy trimester were associated with higher odds of depressive symptoms throughout pregnancy.
Collapse
|
9
|
Paskulin JTA, Drehmer M, Olinto MT, Hoffmann JF, Pinheiro AP, Schmidt MI, Nunes MA. Association between dietary patterns and mental disorders in pregnant women in Southern Brazil. ACTA ACUST UNITED AC 2017; 39:208-215. [PMID: 28355346 PMCID: PMC7111387 DOI: 10.1590/1516-4446-2016-2016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 12/19/2016] [Indexed: 11/22/2022]
Abstract
Objective: To evaluate the association between dietary patterns and mental disorders among pregnant women in southern Brazil. Methods: Cross-sectional study with 712 pregnant women recruited from the Study of Food Intake and Eating Behaviors in Pregnancy (ECCAGe). Food intake assessment was performed using the Food Frequency Questionnaire. Dietary patterns were identified by cluster analysis. The Primary Care Evaluation of Mental Disorders (PRIME-MD) was used to evaluate participants’ mental health. Poisson regression models with robust variance were fitted to estimate prevalence ratios (PR). Results: In the adjusted models, there was a high prevalence of major depressive disorder among women with low fruit intake (43%, PR 1.43, 95%CI 1.04-1.95) and high sweets and sugars intake (91%, PR 1.91, 95%CI 1.19-3.07). Women with a common-Brazilian dietary pattern had higher prevalence of major depressive disorder compared to those with a varied consumption pattern (PR 1.43, 95%CI 1.01-2.02). Low intake of beans was significantly associated with generalized anxiety disorder (PR 1.40, 95%CI 1.01-1.93). Conclusions: Low consumption of fruits and beans and intake of the common-Brazilian dietary pattern during pregnancy were associated with higher prevalence of mental disorders. These results reinforce the importance of an adequate dietary intake to ensure better mental health in pregnancy.
Collapse
Affiliation(s)
- Jéssica T A Paskulin
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Michele Drehmer
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Departamento de Nutrição, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | - Maria T Olinto
- Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos (UNISINOS), São Leopoldo, RS, Brazil.,Departamento de Nutrição, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Juliana F Hoffmann
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Andréa P Pinheiro
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Maria I Schmidt
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Maria A Nunes
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
10
|
Araújo WSD, Romero WG, Zandonade E, Amorim MHC. Effects of relaxation on depression levels in women with high-risk pregnancies: a randomised clinical trial. Rev Lat Am Enfermagem 2016; 24:e2806. [PMID: 27627126 PMCID: PMC5048730 DOI: 10.1590/1518-8345.1249.2806] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 05/16/2016] [Indexed: 01/27/2023] Open
Abstract
Objective: to analyse the effects of relaxation as a nursing intervention on the depression
levels of hospitalised women with high-risk pregnancies. Methods: a randomised clinical trial realised in a reference centre for high-risk
pregnancies. The sample consisted of 50 women with high-risk pregnancies (25 in
the control group and 25 in the intervention group). The Benson relaxation
technique was applied to the intervention group for five days. Control variables
were collected using a predesigned form, and the signs and symptoms of depression
were evaluated using the Edinburgh Postnatal Depression Scale (EPDS). The
Statistical Package for Social Sciences (SPSS), version 20.0, was used with a
significance level of 5%. The Wilcoxon and paired t-tests were used to evaluate
depression levels between two timepoints. Using categorical data, the McNemar test
was used to analyse differences in depression severity before and after the
intervention. Results: depression levels decreased in the intervention group five days after the
relaxation technique was applied (4.5 ± 3, p<0.05) compared with the levels at
the first timepoint (10.3±5.9). Conclusion: as a nursing intervention, relaxation was effective in decreasing the symptoms of
depression in hospitalised women with high-risk pregnancies.
Collapse
Affiliation(s)
- Wanda Scherrer de Araújo
- MSc, RN, Hospital Universitário Cassiano Antonio de Mores, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | | | - Eliana Zandonade
- PhD, Adjunct Professor, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | | |
Collapse
|
11
|
Kassada DS, Waidman MAP, Miasso AI, Marcon SS. Prevalência de transtornos mentais e fatores associados em gestantes. ACTA PAUL ENFERM 2015. [DOI: 10.1590/1982-0194201500084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Identificar a prevalência de transtornos mentais e fatores associados em gestantes. Métodos Estudo transversal realizado com 394 gestantes, selecionadas de forma aleatória e proporcional. Os dados foram coletados nos domicílios, com aplicação de questionário semiestruturado. Para a análise foi utilizada a regressão logística bivariada. Resultados Referiram diagnóstico de transtorno mental 51 gestantes (12,94%) e isto foi significativamente maior entre aquelas com idade entre 19 e 30 anos, sem companheiro, de cor branca, que estavam no segundo trimestre de gestação, tinha alguma doença crônica associada e foi internada na gestação atual. Nove delas faziam uso de psicofármacos, sendo os antidepressivos os mais utilizados. Conclusão A prevalência de transtornos mentais foi de 12,94% e os fatores associados foram: idade, situação conjugal, cor, trimestre de gestação, internação durante a gestação e doença crônica.
Collapse
|
12
|
Association of Prepregnancy Dietary Patterns and Anxiety Symptoms from Midpregnancy to Early Postpartum in a Prospective Cohort of Brazilian Women. J Acad Nutr Diet 2015; 115:1626-35. [PMID: 25769749 DOI: 10.1016/j.jand.2015.01.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 01/16/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Adherence to unhealthy dietary patterns may alter the risk of mental disorders during pregnancy and the postpartum period. OBJECTIVE To analyze the association between prepregnancy dietary patterns and prospective variations on anxiety symptoms from midpregnancy to early postpartum. METHODS A prospective cohort of 207 healthy pregnant women was followed at 5 to 13, 20 to 26, and 30 to 36 gestational weeks, and once at 30 to 45 days postpartum. The State-Trait Anxiety Inventory was used to evaluate anxiety symptoms at the second and third gestational trimesters and during the postpartum period. Dietary intake was assessed using a food frequency questionnaire administered during the first trimester of pregnancy that referred to the 6 months before pregnancy. Principal components analysis was used to identify dietary patterns and three prepregnancy dietary patterns were identified: common-Brazilian, healthy, and processed. Three longitudinal mixed-effect models were estimated to verify the association between dietary patterns and anxiety symptoms, adjusted for confounding variables. RESULTS The mean anxiety symptom scores were 40.4, 40.5, and 37.2 for the second trimester, third trimester, and postpartum, respectively. The rate of variation of the State-Trait Anxiety Inventory score was 0.535 (95% CI -0.035 to 1.107; P=0.066) and -0.010 (95% CI -0.018 to -0.002; P=0.019) when accounting for gestational age and quadratic gestational age, respectively. The common-Brazilian pattern, comprised mainly of rice and beans (β=-1.200, 95% CI -2.220 to -0.181; P=0.021), and the healthy pattern comprised mostly of vegetables, fruits, fish, and tea (β=-1.290, 95% CI -2.438 to -0.134; P=0.029), were negatively associated with prospective changes in anxiety symptoms. CONCLUSIONS High adherence to the common-Brazilian or healthy patterns was negatively associated with higher anxiety symptom scores from mid-pregnancy to early postpartum in this group of Brazilian women.
Collapse
|
13
|
Verly-Miguel MVB, Farias DR, Pinto TDJP, Lepsch J, Nardi AE, Kac G. Serum docosahexaenoic acid (DHA) is inversely associated with anxiety disorders in early pregnancy. J Anxiety Disord 2015; 30:34-40. [PMID: 25591045 DOI: 10.1016/j.janxdis.2014.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 12/05/2014] [Accepted: 12/06/2014] [Indexed: 10/24/2022]
Abstract
Little is known about the association between polyunsaturated fatty acids (PUFAs) and anxiety disorders during pregnancy. We evaluated this association at the first pregnancy trimester in 228 women. The study endpoint was the diagnosis of any anxiety disorder assessed by the Mini International Neuropsychiatric Interview. The independent variables were the serum concentrations of total n-3 and fractions (18:2, 20:5, 22:5, 22:6), total n-6 and fractions (18:2, 18:3, 20:2, 20:3, 20:4, 22:4, 22:5) and the n-6/n-3 ratio PUFAs. The prevalence of any anxiety disorders was 25%. The first tertile of the docosahexaenoic acid (DHA, 22:6 n-3) distribution represented 1.95 (95% CI: 1.00-3.77) higher chance of having an anxiety disorder diagnosis, compared to those in the second and third tertiles after adjusting the analyses for parity, family income, early pregnancy BMI and gestational age at the blood sampling. Serum concentrations of DHA were inversely associated with the occurrence of early pregnancy anxiety disorders.
Collapse
Affiliation(s)
| | - Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, RJ, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, RJ, Brazil
| | - Thatiana de Jesus Pereira Pinto
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, RJ, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, RJ, Brazil
| | - Jaqueline Lepsch
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, RJ, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, RJ, Brazil
| | - Antonio Egidio Nardi
- Laboratory of Panic and Respiration, Institute of Psychiatry, School of Medicine, Federal University of Rio de Janeiro, RJ, Brazil
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, RJ, Brazil.
| |
Collapse
|
14
|
Rebelo F, de Jesus Pereira Pinto T, Franco-Sena AB, Lepsch J, Benaim C, Struchiner CJ, Kac G. Plasma adiponectin is inversely associated with antenatal anxiety: Results from a Brazilian cohort. Psychoneuroendocrinology 2015; 51:92-100. [PMID: 25305545 DOI: 10.1016/j.psyneuen.2014.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 08/14/2014] [Accepted: 09/16/2014] [Indexed: 10/24/2022]
Abstract
Antenatal anxiety may increase the risk of undesirable birth outcomes. Studies have demonstrated an association between adiponectin and anxiety, but this issue has not been investigated during pregnancy. This study aimed to evaluate the association between plasma adiponectin, measured throughout gestation, and the occurrence of anxiety at late pregnancy (30-36th weeks). A prospective cohort was investigated in Rio de Janeiro, Brazil. Healthy pregnant women, aged 20-40 years, were evaluated between gestational weeks 5-13, 22-26 and 30-36. State anxiety was measured using a validated version of the State-Trait Anxiety Inventory, and women were categorized as high (score≥50, n=30) or low anxiety (score<50, n=129). Plasma samples for all trimesters were analyzed using commercial ELISA kits to determine adiponectin concentrations (U/mL). Statistical analysis involved student's t-tests, chi-square, Pearson correlation, multiple logistic regression and linear mixed effects (LME) regression to model longitudinal trends of adiponectin, stratified for anxiety categories. Women with higher anxiety scores had lower mean concentrations of 3rd trimester adiponectin compared with those with lower scores (7.9; 95% CI: 7.0-8.9 vs. 9.9; 95% CI: 9.1-10.7). Women with 3rd trimester adiponectin values within the third tertile (10.47-26.57U/mL) were less likely to have high antenatal anxiety (adjusted OR=0.30; 95% CI: 0.09-0.98) compared with those within the first tertile (2.25-7.08U/mL). Unlike women with low levels of anxiety, those with high levels had a significant decrease of plasma adiponectin throughout pregnancy (β=-0.07; 95% CI: -0.13-[-0.01] vs. β=-0.01; 95% CI: -0.05 to 0.03). Multiple LME model indicated higher adiponectin throughout pregnancy for women with low anxiety (β=-1.57; 95% CI: -2.78-[-0.37]). In conclusion, plasma adiponectin throughout pregnancy was inversely associated with antenatal anxiety.
Collapse
Affiliation(s)
- Fernanda Rebelo
- National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480 Manguinhos, Rio de Janeiro, RJ, Brazil; Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro. Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367/CCS-Bloco J-2° andar, sala 29. Cidade Universitária-Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
| | - Thatiana de Jesus Pereira Pinto
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro. Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367/CCS-Bloco J-2° andar, sala 29. Cidade Universitária-Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
| | - Ana Beatriz Franco-Sena
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro. Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367/CCS-Bloco J-2° andar, sala 29. Cidade Universitária-Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
| | - Jaqueline Lepsch
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro. Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367/CCS-Bloco J-2° andar, sala 29. Cidade Universitária-Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
| | - Camila Benaim
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro. Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367/CCS-Bloco J-2° andar, sala 29. Cidade Universitária-Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
| | - Claudio José Struchiner
- National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480 Manguinhos, Rio de Janeiro, RJ, Brazil.
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro. Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367/CCS-Bloco J-2° andar, sala 29. Cidade Universitária-Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
| |
Collapse
|
15
|
HDL-cholesterol concentrations are inversely associated with Edinburgh Postnatal Depression Scale scores during pregnancy: results from a Brazilian cohort study. J Psychiatr Res 2014; 58:181-8. [PMID: 25163727 DOI: 10.1016/j.jpsychires.2014.07.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 07/23/2014] [Accepted: 07/24/2014] [Indexed: 11/23/2022]
Abstract
Serum lipids have been associated with depression in the adult population; however, this association during pregnancy remains unclear. The aim of this study was to evaluate the association between serum lipids and depressive symptom scores during pregnancy. A prospective cohort of 238 pregnant women was followed at the 5th-13th, 20th-26th and 30th-36th weeks of gestation. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Serum concentrations (mg/dL) of triglycerides, total cholesterol, and low- and high-density lipoproteins (LDL-c; HDL-c) were the main exposures. Marital status (married/single), physical activity (active or very active/low or very low active), unplanned pregnancy (no/yes), pre-pregnancy BMI (<25/≥ 25 kg/m(2)), generalized anxiety disorder (no/yes) and current suicidal ideation (no/yes) were considered as potential confounders. Analyses were performed using linear mixed-effects models. The results showed that the EPDS mean score (95%CI) decreased with time during pregnancy trimesters [1st: 8.89 (95%CI = 8.28-9.51), 2nd: 7.32 (95%CI = 6.67-7.97) and 3rd: 7.08 (95%CI = 6.41-7.74)]. Suicidal ideation frequency at baseline was 18%. HDL-c concentrations were inversely associated with changes in EPDS score (β = -0.080, 95%CI = -0.157 to -0.002), while low or very low active women (β = 1.288, 95%CI = 0.630-1.946), with single marital status (β = 1.348, 95%CI = 0.163-2.534), unplanned pregnancy (β = 1.922, 95%CI = 0.714-3.131), generalized anxiety disorder (β = 2.139, 95%CI = 0.410-3.868) and current suicidal ideation (β = 1.927, 95%CI = 0.596-3.258) tended to have higher EPDS scores. No relationship was observed between other lipids and EPDS scores. HDL-c concentration was inversely associated with changes in depressive symptom scores during pregnancy after adjusting for socio-economic, demographic, behavioral, nutritional, biochemical and mental health disorders.
Collapse
|
16
|
Ferreira CR, Orsini MC, Vieira CR, do Amarante Paffaro AM, Silva RR. Prevalence of anxiety symptoms and depression in the third gestational trimester. Arch Gynecol Obstet 2014; 291:999-1003. [PMID: 25311200 DOI: 10.1007/s00404-014-3508-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 10/07/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the prevalence of anxiety and gestational depression and to determine the risk factors associated to its development. METHOD Pregnant women during their third quarter of pregnancy were invited to participate to the study, and they signed an informed consent form. After that, they filled in a general assessment questionnaire in which socio-economical and obstetrical characteristics together with general health conditions and behaviors harmful for the pregnancy were evaluated. To determine the anxiety symptoms a STAI A-trait scale and a STAI-A-state scale were used and to measure the depression a CES-D scale was used. A data logistic regression was realized to determine significant associations. The significance level adopted was 0.05 for all statistical tests. RESULTS The final sample was represented by 207 pregnant women and the prevalence of depression was the highest value (73.5%), followed by state anxiety (58.5%) and finally by trait anxiety (53.2%). Only trait anxiety was explained by the variables studied and it was associated to the realization of a treatment for chronic diseases (OR = 2.93; IC = 1.02-8.41; p = 0.045) and the usage of continuous prescription drugs (OR = 2.30; IC = 1.06-4.97; p = 0.034). CONCLUSIONS The prevalence of anxiety and depression among pregnant women were both high and only trait anxiety was explained by treatment for chronic diseases and the usage of continuous prescription drugs.
Collapse
Affiliation(s)
- Caroline Ronchini Ferreira
- Faculdade de Nutrição, Universidade Federal de Alfenas (UNIFAL-MG), Rua Gabriel Monteiro da Silva, 700, Alfenas, MG, 37130-000, Brazil,
| | | | | | | | | |
Collapse
|
17
|
Gonçalves DA, Mari JDJ, Bower P, Gask L, Dowrick C, Tófoli LF, Campos M, Portugal FB, Ballester D, Fortes S. Brazilian multicentre study of common mental disorders in primary care: rates and related social and demographic factors. CAD SAUDE PUBLICA 2014; 30:623-32. [PMID: 24714951 DOI: 10.1590/0102-311x00158412] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 09/16/2013] [Indexed: 11/22/2022] Open
Abstract
Mental health problems are common in primary health care, particularly anxiety and depression. This study aims to estimate the prevalence of common mental disorders and their associations with socio-demographic characteristics in primary care in Brazil (Family Health Strategy). It involved a multicenter cross-sectional study with patients from Rio de Janeiro, São Paulo, Fortaleza (Ceará State) and Porto Alegre (Rio Grande do Sul State), assessed using the General Health Questionnaire (GHQ-12) and the Hospital Anxiety and Depression Scale (HAD). The rate of mental disorders in patients from Rio de Janeiro, São Paulo, Fortaleza and Porto Alegre were found to be, respectively, 51.9%, 53.3%, 64.3% and 57.7% with significant differences between Porto Alegre and Fortaleza compared to Rio de Janeiro after adjusting for confounders. Prevalence proportions of mental problems were especially common for females, the unemployed, those with less education and those with lower incomes. In the context of the Brazilian government's moves towards developing primary health care and reorganizing mental health policies it is relevant to consider common mental disorders as a priority alongside other chronic health conditions.
Collapse
|
18
|
Cruz L, Lima AFDS, Graeff-Martins A, Maia CRM, Ziegelmann P, Miguel S, Fleck M, Polanczyk C. Mental health economics: insights from Brazil. J Ment Health 2013; 22:111-21. [PMID: 23574503 DOI: 10.3109/09638237.2012.759193] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND As the responsibility and demand on health care grows and resources do not increase at the same pace, the healthcare system has been forced to reconsider the benefits and costs of their actions, to ensure a rational and effective decision-making process regarding the adoption of interventions and allocation of resources. Cost-effectiveness (CE) studies represent one of the basic tools to achieve this goal. AIMS To present the current state of Health Technology Assessment (HTA) and health economics in mental health in Brazil and its importance to the decision-making process. METHODOLOGY Descriptive paper on HTA and health economics in Brazil. Databases from government and universities as well as some scientific databases to assess the information are presented. RESULTS AND CONCLUSION Economic analysis to evaluate interventions in mental health care is a relatively recent addition to the field of health economics; in Brazil, it is also considered a topic within Epidemiology research area. There have been an increased number of studies developed in high-income countries. However, there are fewer CE studies in low- and middle-income ones. Psychiatric disorders represent a significant burden in developing countries, where resources devoted to health care are even scarcer.
Collapse
Affiliation(s)
- Luciane Cruz
- Health Technology Assessment Institute IATS, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | | | | | | | | | | | | |
Collapse
|