16 research outputs found
PrevalĂȘncia do risco para transtornos mentais e suicĂdio em estudantes dos cursos superiores de medicina e de direito
Orientadora: Profa. Dra. LĂșcia Helena Coutinho dos Santos (in Memoriam)Coorientadora: Profa. Dra. MĂŽnica Nunes LimaTese (doutorado) - Universidade Federal do ParanĂĄ, Setor de CiĂȘncias da SaĂșde, Programa de PĂłs-Graduação em SaĂșde da Criança e do Adolescente. Defesa : Curitiba, 27/07/2016Inclui referĂȘnciasResumo: UniversitĂĄrios sĂŁo vulnerĂĄveis para o desenvolvimento de Transtornos Mentais (TM). De acordo com a Associação Nacional dos Dirigentes das InstituiçÔes Federais de Ensino Superior (Andifes, 2011) 47,7% dos universitĂĄrios no Brasil referiram ter vivenciado alguma crise emocional durante sua formação acadĂȘmica, caracterizadas principalmente por DepressĂŁo (22%) e Ansiedade (70%). O objetivo deste estudo foi verificar a prevalĂȘncia dos principais riscos para TM e SuicĂdio em estudantes dos cursos de Medicina e Direito. Trata-se de estudo prospectivo de 1048estudantes da Universidade Federal do ParanĂĄ - 775 do curso de Medicina e 273 de Direito, que responderam aos instrumentos: 1) Adult Self Report-ASR e 2) WHOQOL-100. O ASR Ă© um inventĂĄrio de autoavaliação destinado Ă adultos de 18 a 59 anos que permite verificar aspectos do Funcionamento Adaptativo e PsicopatolĂłgico do indivĂduo. Um escore igual ou acima de 70 Ă© considerado ClĂnico, entre 65 e 69,LimĂtrofe e abaixo de 64, Normal. O WHOQOL-100 Ă© um instrumento para avaliação de Qualidade de Vida com resultado expresso em porcentagem, variando de 0 a100%. Valores entre 0% e 25% foram considerados como Qualidade de Vida Ruim,entre 26% e 50%, Moderada, entre 51% e 75% Boa e entre 76% e 100%, Ătima. A prevalĂȘncia geral de risco de TM foi de 48,7%. Um a cada dois estudantes de Medicina e de Direito apresentaram escore do ASR ClĂnico e 65,1% LimĂtrofe, com predomĂnio do sexo feminino e 3Âș ano em ambos os cursos. Os principais riscos para TM observados em nĂvel ClĂnico pelo DSM-Orientado foram Problemas de Ansiedade(20,4%), Problemas de DepressĂŁo (14,7%) e Personalidade Evitativa (14,9%).Problemas Internalizantes (ASR) foram observados em 35,8% dos casos representados por SĂndrome Ansiedade/DepressĂŁo (18,0%) e Isolamento (14,2%).Itens CrĂticos EspecĂficos em nĂvel ClĂnico tiveram elevada prevalĂȘncia representados por "Dificuldade de Atenção/Concentração" (26,1%), "ObsessĂ”es" (19,9%), "Oscilação de Humor" (18,5%), "Consumir Ălcool ou Ficar BĂȘbado" (15,5%) e "Chorar Muito"(11,2%). Comprometimento no Funcionamento-Adaptativo Geral esteve associado a todos os itens do ASR, Ă exceção do Uso de Ălcool. Qualidade de Vida Geral Ruim ou Moderada foi encontrada em 30% dos estudantes e em 50% nos DomĂnios FĂsico e PsicolĂłgico do WHOQOL-100. A prevalĂȘncia de risco de SuicĂdio foi de 11,5% e a presença de qualquer Problema do DSM-Orientado em nĂvel ClĂnico aumentou o risco de SuicĂdio em 5 vezes (RR = 5,09 IC 95% = 3,47â7,47) e pelo ASR em 6,5 vezes(RR = 6,45 IC = 95% = 3,92â10,62), associado principalmente a Problemas Internalizantes, Problemas de DepressĂŁo, Problemas de Ansiedade e Personalidade Evitativa. Cerca de 50% deles apresentava de uma a trĂȘs sĂndromes associadas. InstituiçÔes de Ensino Superior devem implementar estratĂ©gias de prevenção, diagnĂłstico precoce e orientação terapĂȘutica multidisciplinar a fim de garantir possibilidade de se graduar com qualidade de vida adequada e compatĂvel com a fase de juventude.Abstract: University students are the most likely to develop Mental Disorder (MD).
According to the Brazilian National Association of Federal Institutions of Higher
Education Leaders (ANDIFES - Associação Nacional dos Dirigentes das InstituiçÔes
Federais de Ensino Superior) 47.7% of the Brazilian university students suffer some
kind of emotional crisis during their academic life, mainly depression (22%) and anxiety
(70%). The main goal of this research was to verify the preponderance of fundamental
risks of MD and suicidal behavior during the courses of Law and Medicine. The
prospective study brought together data of 1048 students of the Federal University of
Parana â Brazil, 775 majoring in medicine and the other 273 in law that responded to
the psychopathology and life quality instruments: 1) Adult self-report â ASR and 2)
WHOQOL-100). ASR is an inventory of self evaluation focused on adults from 18 to
59 years what allow to verify aspects of the individual's adaptive and
psychopathological functioning. A score above or equal to 70 is considered a Clinical
case, from 65 to 69 Borderline and below 64 Normal. The WHOQOL 100 is an
instrument to avaliate quality of life with a result expressed in percentage, ranging from
0 to 100%. Values between 0% and 25% were rated as Bad life quality, among 26%
and 50% Moderate, from 51% to 75% Good and Great quality of life were those within
76% and 100%. The general prevalence of MD risk was 48.7%. One every two
students on the case showed Clinic ASR score and 65.1% Borderline score, with the
predominance of women and of the 3rd year in both fields of study. The biggest risks
of MD observed in Clinic level for DSM-oriented were Anxiety Problems (20.4%),
Depressive Problems (14.7%) and Avoidant Personality Problems (14.9%).
Internalizing Problems (ASR) were noticed in 38.5% of the cases represented by
Anxious/Depressed Syndrome (18.0%) and Withdrawn (14.2%). Specifical Critical
Items on a Clinic level had an elevated prevalence represented by ââdifficulties of
concentration and paying attentionââ (26%), ââobsessionsââ (19.9%), ââoscillations of
humorââ (18.5%), ââdrinking problemsââ (15.5%), ââcrying a lotââ (11.2%). Commitment on
the Adaptative Functioning in general was associated with all items of ASR, with the
exception of the alcohol consuming issue. An average or bad quality of life was
checked by 30% of the students and in 50% of physical and psychological domains of
WHOQOL-100. The prevalence risk of suicidal behaviours was of 11.5% and the
presence of any DSM-oriented problem in clinical level multiplied the risk of suicide in
5 times (OR= 5.09 IC 95%= 3.47-7.47) and for the ASR in 6,5 times (OR = 6.45
IC = 95% = 3.92â10.62), associated mainly with Internalizing Problems, Anxiety
Problems, Depressed Problems and Avoidant Personality Problems. About 50% of
them presented from one to three correlated syndromes. Superior Educations
Institutions must implement preventive strategies, early diagnosis and multidisciplinary
therapeutic orientation in order to guarantee to its students the possibility to graduate
with an adequate and compatible life quality to the youth
DiscrepĂąncias no crescimento dos dimĂdios em crianças com paralisia cerebral hemiplĂ©gica: associação com a função, atividades e participação social
Objective: Evaluate side-to-side discrepancies in children with hemiplegic cerebral palsy (HCP), and investigate associations of these discrepancies with patientsâ age at initiation of physical therapy, motor and cognitive function, and degree of activities and social participation. Method: We obtained eight side-to-side measurements from 24 HCP children with mean age 49.3±5.2 months. Results: Early initiation of physical therapy was associated with lower discrepancy in hand length (p=0.037). Lower foot length discrepancy was associated with lower requirement for caregiver assistance in activities related to mobility. Increased side-to-side discrepancy was associated with reduced wrist extension and increased spasticity. Discrepancy played a larger role in children with hemineglect and in those with right involvement. Conclusion: Increased discrepancy in HCP children was associated with reduced degree of activity/social participation. These results suggest an association between functional use of the extremities and limb growth.Objetivo: Avaliar a discrepĂąncia entre o crescimento dos lados do corpo em crianças com paralisia cerebral hemiplĂ©gica (PCH), e investigar sua associação com a idade de inĂcio do tratamento de fisioterapia, função motora e cognitiva, grau de atividades e participação social. MĂ©todo: Comparamos oito medidas obtidas de 24 crianças com PCH e com mĂ©dia de idade de 49,3±5,2 meses. Resultados: O inĂcio precoce da fisioterapia se relacionou Ă menor discrepĂąncia no comprimento da mĂŁo (p=0,037). A menor discrepĂąncia no comprimento do pĂ© se relacionou Ă menor necessidade de ajuda do cuidador em atividades de mobilidade. A maior discrepĂąncia esteve relacionada Ă menor extensĂŁo de punho e Ă maior espasticidade. A discrepĂąncia foi mais importante em crianças com heminegligĂȘncia e com envolvimento Ă direita. ConclusĂŁo: Crianças com PCH com maior discrepĂąncia apresentaram menor atividade/participação social. Os resultados sugerem associação entre o uso funcional da mĂŁo e o crescimento das extremidades.CuritibaPRUniversidade Federal do ParanĂĄ Hospital de ClĂnicas Centro de NeuropediatriaSĂŁo PauloSPUniversidade Federal de SĂŁo Paulo (UNIFESP)Universidade Federal do ParanĂĄ Departamento de PediatriaUniversidade Federal do ParanĂĄ Departamento de ClĂnica MĂ©dicaHospital Albert EinsteinUNIFESPSciEL
130 anos de evidĂȘncias: risco de suicĂdio entre mĂ©dicos e estudantes de medicina
Objective: To evaluate the incidence of risk of Mental Disorders (MD), Suicide and Quality of Life in medical students. Methods: This is a prospective cross-sectional study conducted at a Public Higher Education Institution of Medicine in Southern Brazil. Evaluation of 775 students who responded in person to Adult Self Repport (ASR) and WHOQOL-100, with individual return of results, orientation and mandatory referral for those with âBorderlineâ and âClinicalâ scores and optional for those with âNormalâ score. Results: The incidence of MD risk was 54.3% and suicide risk was 10.6%. Internalizing Problems were observed in 34.7% of cases and Externalizing Problems in 12.6%. Among the most frequent syndromes, Anxiety/Depression, Isolation and Attention were highlighted. âPoorâ or âModerateâ Overall Quality of Life was observed in about 30%, associated with adaptive functioning and the presence of DSM-Oriented or ASR problems at âClinicalâ level (p <0.001). The main variables for suicide risk were Anxiety/Depression Problems, Internalizing Problems, Thought Problems, and Antisocial Personality (p <0.001). âClinicalâ Score for two or more Syndromes or Total Problems was selected as an independent variable for the risk of suicide, while the Spirituality and Psychological domains were appointed as protective (p <0.001). Conclusions: There was a high incidence of MD associated with poor quality of life and increased risk of suicide among medical students.Objetivo: Avaliar a incidĂȘncia de risco para Transtornos Mentais (TM), SuicĂdio e Qualidade de Vida em estudantes de Medicina. MĂ©todos: Estudo transversal, prospectivo realizado em Instituição PĂșblica de Ensino Superior de Medicina do Sul do Brasil. Avaliação de 775 estudantes que responderam presencialmente ao Adult Self Repport (ASR) e WHOQOL-100, com devolução individual do resultado, orientação e encaminhamento obrigatĂłrio para aqueles com escores âLimĂtrofeâ e âClĂnicoâ e opcional para os com escore âNormalâ. Resultados: A incidĂȘncia de risco de TM foi de 54,3% e de risco de suicĂdio de 10,6%. Problemas Internalizantes foram observados em 34,7% e Problemas Externalizantes em 12,6%. Entre as sĂndromes mais frequentes, destacaram-se Ansiedade/DepressĂŁo; Isolamento e Problemas de Atenção. Qualidade de vida geral âRuimâ ou âModeradaâ foi observada em cerca de 30%, associada a funcionamento adaptativo e presença de Problemas do DSM-Orientado ou ASR em nĂvel âClĂnicoâ (p<0,001). As principais variĂĄveis para o risco de suicĂdio foram: Ansiedade/DepressĂŁo; Problemas Internalizantes, Problemas de Pensamento e Personalidade Antissocial (p <0,001). Escore âClĂnicoâ para duas ou mais SĂndromes ou Total de Problemas foi selecionado como variĂĄvel independente para o risco de SuicĂdio enquanto os domĂnios Espiritualidade e PsicolĂłgico foram apontados como protetores (p<0,001). ConclusĂ”es: Observou-se elevada incidĂȘncia de TM, associado a qualidade de vida ruim e aumento do risco de suicĂdio entre estudantes de Medicina
PrevalĂȘncia do risco para transtornos mentais e suicĂdio em estudantes dos cursos superiores de medicina e de direito
Orientadora: Profa. Dra. LĂșcia Helena Coutinho dos Santos (in Memoriam)Coorientadora: Profa. Dra. MĂŽnica Nunes LimaTese (doutorado) - Universidade Federal do ParanĂĄ, Setor de CiĂȘncias da SaĂșde, Programa de PĂłs-Graduação em SaĂșde da Criança e do Adolescente. Defesa : Curitiba, 27/07/2016Inclui referĂȘnciasResumo: UniversitĂĄrios sĂŁo vulnerĂĄveis para o desenvolvimento de Transtornos Mentais (TM). De acordo com a Associação Nacional dos Dirigentes das InstituiçÔes Federais de Ensino Superior (Andifes, 2011) 47,7% dos universitĂĄrios no Brasil referiram ter vivenciado alguma crise emocional durante sua formação acadĂȘmica, caracterizadas principalmente por DepressĂŁo (22%) e Ansiedade (70%). O objetivo deste estudo foi verificar a prevalĂȘncia dos principais riscos para TM e SuicĂdio em estudantes dos cursos de Medicina e Direito. Trata-se de estudo prospectivo de 1048estudantes da Universidade Federal do ParanĂĄ - 775 do curso de Medicina e 273 de Direito, que responderam aos instrumentos: 1) Adult Self Report-ASR e 2) WHOQOL-100. O ASR Ă© um inventĂĄrio de autoavaliação destinado Ă adultos de 18 a 59 anos que permite verificar aspectos do Funcionamento Adaptativo e PsicopatolĂłgico do indivĂduo. Um escore igual ou acima de 70 Ă© considerado ClĂnico, entre 65 e 69,LimĂtrofe e abaixo de 64, Normal. O WHOQOL-100 Ă© um instrumento para avaliação de Qualidade de Vida com resultado expresso em porcentagem, variando de 0 a100%. Valores entre 0% e 25% foram considerados como Qualidade de Vida Ruim,entre 26% e 50%, Moderada, entre 51% e 75% Boa e entre 76% e 100%, Ătima. A prevalĂȘncia geral de risco de TM foi de 48,7%. Um a cada dois estudantes de Medicina e de Direito apresentaram escore do ASR ClĂnico e 65,1% LimĂtrofe, com predomĂnio do sexo feminino e 3Âș ano em ambos os cursos. Os principais riscos para TM observados em nĂvel ClĂnico pelo DSM-Orientado foram Problemas de Ansiedade(20,4%), Problemas de DepressĂŁo (14,7%) e Personalidade Evitativa (14,9%).Problemas Internalizantes (ASR) foram observados em 35,8% dos casos representados por SĂndrome Ansiedade/DepressĂŁo (18,0%) e Isolamento (14,2%).Itens CrĂticos EspecĂficos em nĂvel ClĂnico tiveram elevada prevalĂȘncia representados por "Dificuldade de Atenção/Concentração" (26,1%), "ObsessĂ”es" (19,9%), "Oscilação de Humor" (18,5%), "Consumir Ălcool ou Ficar BĂȘbado" (15,5%) e "Chorar Muito"(11,2%). Comprometimento no Funcionamento-Adaptativo Geral esteve associado a todos os itens do ASR, Ă exceção do Uso de Ălcool. Qualidade de Vida Geral Ruim ou Moderada foi encontrada em 30% dos estudantes e em 50% nos DomĂnios FĂsico e PsicolĂłgico do WHOQOL-100. A prevalĂȘncia de risco de SuicĂdio foi de 11,5% e a presença de qualquer Problema do DSM-Orientado em nĂvel ClĂnico aumentou o risco de SuicĂdio em 5 vezes (RR = 5,09 IC 95% = 3,47â7,47) e pelo ASR em 6,5 vezes(RR = 6,45 IC = 95% = 3,92â10,62), associado principalmente a Problemas Internalizantes, Problemas de DepressĂŁo, Problemas de Ansiedade e Personalidade Evitativa. Cerca de 50% deles apresentava de uma a trĂȘs sĂndromes associadas. InstituiçÔes de Ensino Superior devem implementar estratĂ©gias de prevenção, diagnĂłstico precoce e orientação terapĂȘutica multidisciplinar a fim de garantir possibilidade de se graduar com qualidade de vida adequada e compatĂvel com a fase de juventude.Abstract: University students are the most likely to develop Mental Disorder (MD).
According to the Brazilian National Association of Federal Institutions of Higher
Education Leaders (ANDIFES - Associação Nacional dos Dirigentes das InstituiçÔes
Federais de Ensino Superior) 47.7% of the Brazilian university students suffer some
kind of emotional crisis during their academic life, mainly depression (22%) and anxiety
(70%). The main goal of this research was to verify the preponderance of fundamental
risks of MD and suicidal behavior during the courses of Law and Medicine. The
prospective study brought together data of 1048 students of the Federal University of
Parana â Brazil, 775 majoring in medicine and the other 273 in law that responded to
the psychopathology and life quality instruments: 1) Adult self-report â ASR and 2)
WHOQOL-100). ASR is an inventory of self evaluation focused on adults from 18 to
59 years what allow to verify aspects of the individual's adaptive and
psychopathological functioning. A score above or equal to 70 is considered a Clinical
case, from 65 to 69 Borderline and below 64 Normal. The WHOQOL 100 is an
instrument to avaliate quality of life with a result expressed in percentage, ranging from
0 to 100%. Values between 0% and 25% were rated as Bad life quality, among 26%
and 50% Moderate, from 51% to 75% Good and Great quality of life were those within
76% and 100%. The general prevalence of MD risk was 48.7%. One every two
students on the case showed Clinic ASR score and 65.1% Borderline score, with the
predominance of women and of the 3rd year in both fields of study. The biggest risks
of MD observed in Clinic level for DSM-oriented were Anxiety Problems (20.4%),
Depressive Problems (14.7%) and Avoidant Personality Problems (14.9%).
Internalizing Problems (ASR) were noticed in 38.5% of the cases represented by
Anxious/Depressed Syndrome (18.0%) and Withdrawn (14.2%). Specifical Critical
Items on a Clinic level had an elevated prevalence represented by ââdifficulties of
concentration and paying attentionââ (26%), ââobsessionsââ (19.9%), ââoscillations of
humorââ (18.5%), ââdrinking problemsââ (15.5%), ââcrying a lotââ (11.2%). Commitment on
the Adaptative Functioning in general was associated with all items of ASR, with the
exception of the alcohol consuming issue. An average or bad quality of life was
checked by 30% of the students and in 50% of physical and psychological domains of
WHOQOL-100. The prevalence risk of suicidal behaviours was of 11.5% and the
presence of any DSM-oriented problem in clinical level multiplied the risk of suicide in
5 times (OR= 5.09 IC 95%= 3.47-7.47) and for the ASR in 6,5 times (OR = 6.45
IC = 95% = 3.92â10.62), associated mainly with Internalizing Problems, Anxiety
Problems, Depressed Problems and Avoidant Personality Problems. About 50% of
them presented from one to three correlated syndromes. Superior Educations
Institutions must implement preventive strategies, early diagnosis and multidisciplinary
therapeutic orientation in order to guarantee to its students the possibility to graduate
with an adequate and compatible life quality to the youth
Evaluation of the Pediatric Symptom Checklist as a screening tool for the identification of emotional and psychosocial problems
OBJECTIVE To investigate the Brazilian version of Pediatric Symptom Checklist (PSC) as a screening tool to identify psychosocial and emotional problems in schoolchildren from six to 12 years old. METHODS Diagnostic test conducted in a public school of Curitiba, Paraná (Southern Brazil), to evaluate the PSC accuracy and consistency, considering the Child Behavior Checklist (CBCL) as the gold standard. Among 415 parents invited for the study, 145 responded to both PSC and CBCL. The results of the two instruments were compared. PSC and CBCL were considered positive if scores ≥28 and >70 respectively. RESULTS Among the 145 cases, 49 (33.8%) were positive for both PSC and CBCL. The ROC curve showed the PSC score of 21 as the best cutoff point for screening psychosocial and emotional problems, with a sensitivity of 96.8% and a specificity of 86.7%. Regarding the reference cutoff (score ≥28 points), the sensitivity was 64.5% and the specificity, 100.0%, similar to those found in the original version of the tool. CONCLUSIONS The Portuguese version of PSC was effective for early identification of emotional and/or psychosocial problems in a schoolchildren group and may be useful for pediatricians
Effects of early spasticity treatment on children with hemiplegic cerebral palsy: a preliminary study
Objective To compare motor and functional performance of two groups of children with hemiplegic cerebral palsy (HCP). Only the study group (SG) received early treatment of spasticity with botulinum neurotoxin type A (BXT-A). Methods Gross Motor Function Measure (GMFM), functional performance (Pediatric Evaluation of Disability Inventory - PEDI), range of movement, gait pattern (Physician Rating Scale - PRS) and the speed of hand movements were considered. Results The SG, composed of 11 HCP (45.64±6.3 months), was assessed in relation to the comparison group, composed of 13 HCP (45.92±6.4 months). SG showed higher scores in four of the five GMFM dimensions, which included scores that were statistically significant for dimension B, and higher scores in five of the six areas evaluated in the PEDI. Active wrist extension, the speed of hand movements and PRS score were higher in the SG. Conclusion Children who received early BXT-A treatment for spasticity showed higher scores in motor and functional performance