Barreto Felipe José Nascimento, Garcia Frederico Duarte, Prado Paulo Henrique Teixeira, Rocha Paulo Marcos Brasil, Las Casas Nádia Souza, Vallt Felipe Barbosa, Correa Humberto, Neves Maila Castro Lourenço
Felipe José Nascimento Barreto, Frederico Duarte Garcia, Nádia Souza Las Casas, Felipe Barbosa Vallt, Maila Castro Lourenço Neves, Department of Mental Health, Federal University of Minas Gerais, Avenida Alfredo Balena, CEP 30130-100 Belo Horizonte, Brazil.
World J Psychiatry. 2017 Jun 22;7(2):106-113. doi: 10.5498/wjp.v7.i2.106.
To identify factors associated with depressive symptoms among inpatients with cardiovascular disease (CVD).
This is a cross-sectional study performed in a subsample of a large cross-sectional research that investigated affective disorders and suicide behaviour among inpatients hospitalized in non-surgical wards of the University Hospital of the Federal University of Minas Gerais from November 2013 to October 2015. Sociodemographic and clinical data were obtained through a structured interview and medical record review. Depression was assessed by the depression subscale of the Hospital Anxiety and Depression Scale, with scores ≥ 8 considered as positive screening for depression. We used the Fageström Test for Nicotine Dependence to characterize nicotine dependence. For assessing resilience and early-life trauma, we used the raw scores of the Wagnild and Young Resilience Scale and Childhood Trauma Questionnaire, respectively.
At endpoint, we included 137 subjects. Thirty-eight (27.7%) subjects presented depressive symptoms and nine (23.7%) of those were receiving antidepressant treatment during hospitalization. The female sex; a lower mean educational level; a greater prevalence of previous suicide attempts; a higher level of pain; a higher prevalence of family antecedents of mental disorders; a lower resilience score; and higher childhood trauma score were the factors significantly associated with screening positive for major depression ( < 0.05). Multivariate analysis demonstrated that the factors independently associated with the depressive symptoms were a higher childhood trauma severity (OR = 1.06; = 0.004); moderate to severe nicotine dependence (OR = 8.58; = 0.008); and the number of previous hospital admissions (OR = 1.11; = 0.034). The obtained logistic model was considered valid, indicating that the three factors together distinguished between having or not depressive symptoms, and correctly classified 74.6% of individuals in the sample.
Our results demonstrate that inpatients presenting both CVD and a positive screening for depression are more prone to have antecedents of childhood trauma, nicotine dependence and a higher number of previous hospitalizations.
确定心血管疾病(CVD)住院患者中与抑郁症状相关的因素。
这是一项横断面研究,是在一项大型横断面研究的子样本中进行的,该大型研究调查了2013年11月至2015年10月在米纳斯吉拉斯联邦大学医院非手术病房住院患者中的情感障碍和自杀行为。通过结构化访谈和病历审查获取社会人口学和临床数据。采用医院焦虑抑郁量表的抑郁分量表评估抑郁情况,得分≥8分被视为抑郁筛查阳性。我们使用尼古丁依赖的法格斯特伦测试来描述尼古丁依赖情况。为评估心理弹性和童年创伤,我们分别使用了瓦格尼尔德和扬心理弹性量表及儿童创伤问卷的原始得分。
在研究终点,我们纳入了137名受试者。38名(27.7%)受试者出现抑郁症状,其中9名(23.7%)在住院期间接受抗抑郁治疗。女性;平均教育水平较低;既往自杀未遂的患病率较高;疼痛程度较高;精神障碍家族史患病率较高;心理弹性得分较低;童年创伤得分较高是与重度抑郁筛查阳性显著相关的因素(<0.05)。多因素分析表明,与抑郁症状独立相关的因素是童年创伤严重程度较高(比值比[OR]=1.06;P=0.004);中度至重度尼古丁依赖(OR=8.58;P=0.008);以及既往住院次数(OR=1.11;P=0.034)。所获得的逻辑模型被认为有效,表明这三个因素共同区分了有无抑郁症状,并正确分类了样本中74.6%的个体。
我们的结果表明,同时患有CVD且抑郁筛查呈阳性的住院患者更容易有童年创伤史、尼古丁依赖和既往住院次数较多。