Diego de Lima Fonseca

Depressão durante a gestação: um estudo sobre a associação entre fatores de risco e de apoio social entre gestantes

A ausencia de apoio social e outros fatores podem tornar gestantes mais suscetiveis a ocorrencia de transtornos mentais como a depressao. O objetivo deste estudo foi investigar a associacao entre apoio social percebido e prevalencia de depressao em gestantes atendidas em uma unidade basica de saude de Nova Iguacu, Rio de Janeiro. Participaram dele 100 gestantes, das quais foram verificadas as caracteristicas sociodemograficas, condicoes medicas/obstetricas, eventos estressantes e apoio social. A depressao foi avaliada pela Composite International Diagnostic Interview. A prevalencia da depressao na gravidez foi 18% (IC95% 12,2-23,8), sendo os fatores associados na analise final: estar solteira, desempregada, possuir historia anterior de depressao e tabagismo. Houve relacao entre a falta de apoio social e a depressao na analise inicial (p<0,05). A ausencia de apoio de informacao e interacao durante o periodo pre-natal, e sua associacao inicial com a depressao, evidencia a fragilidade do servico de saude no atendimento integral as gestantes. Nossos resultados demonstram que intervencoes psicossociais e politicas sociais deveriam ser implementadas para esta populacao.

Depressão e apoio social em gestantes de fetos com malformações atendidas em um hospital materno-infantil público de referência no Rio de Janeiro

INTRODUCTION: The pregnancy and postnatal period are the time of major prevalence of depression in womens life. Obstetric complications, including congenital malformations are important risk factors for depression during pregnancy. Mothers of fetuses with malformations experience a severe stressful life event. This fact could be aggravated by lack of social support. OBJECTIVE: The present study aimed to estimate depression in pregnant women with fetal malformations attended at a reference hospital fetal malformations in the Rio de Janeiro. METHOD: Interviews were conducted with 86 mothers of fetuses with malformations, which were assessed sociodemographic characteristics, clinical conditions/obstetric diagnosis of depression, social support and stressful life event. The period of study was from August 2011 to July 2012. RESULTS:The prevalence of depression during pregnancy was 17.4% (95%CI 0.09-0.26) and associated factor included being unemployed. The lack of emotional and information supports showed the highest frequency (57%). CONCLUSION:Depression is common during pregnancy of women with fetal malformations and was associated with indicators of socioeconomic deprivation. Psychosocial interventions and appropriate social policies need to be implemented in this population to reduce the burden of maternal depression.Introduction: The pregnancy and postnatal period are the time of major prevalence of depression in women’s life. Obstetric complications, including congenital malformations are important risk factors for depression during pregnancy. Mothers of fetuses with malformations experience a severe stressful life event. This fact could be aggravated by lack of social support. Objective: The present study aimed to estimate depression in pregnant women with fetal malformations attended at a reference hospital fetal malformations in the Rio de Janeiro. Method: Interviews were conducted with 86 mothers of fetuses with malformations, which were assessed sociodemographic characteristics, clinical conditions/obstetric diagnosis of depression, social support and stressful life event. The period of study was from August 2011 to July 2012. Results: The prevalence of depression during pregnancy was 17.4% (95%CI 0.09–0.26) and associated factor included being unemployed. The lack of emotional and information supports showed the highest frequency (57%). Conclusion: Depression is common during pregnancy of women with fetal malformations and was associated with indicators of socioeconomic deprivation. Psychosocial interventions and appropriate social policies need to be implemented in this population to reduce the burden of maternal depression.

CONNECT – Uma medida de continuidade do cuidado em serviços de saúde mental: adaptação transcultural e confiabilidade da escala

Objective Perform evidence studies and cross-cultural adaptation and the reliability of the Portuguese version (Brazil) of the CONNECT – A measure of continuity of care in mental health services, in a sample of 50 individuals with severe mental illnesses. Methods The cross-cultural adaptation was performed according to the process of translation and adaptation of instruments (WHO). Reliability was assessed by internal consistency by Cronbach’s alpha coefficient and by stability over time through the weighted kappa, kappa adjusted for prevalence (PABAK) and intraclass correlation coefficient (ICC). Results The process of translation and back translation of CONNECT resulted in the Portuguese version adapted to Brazilian culture. In the assessment of reliability for PABAK, 34 items showed moderate reliability and significant or almost perfect. The agreement by the ICC was weak or poor for three subscales, but since most of the items presented agreement percentage above 50%. The internal consistency by Cronbach’s alpha was moderate to high for three subscales and to the composition of full scalle denoting the appropriateness and consistency of the items. Conclusion CONNECT is the first measure of continuity of care adapted to the Brazilian cultural context. Its adaptation showed satisfactory suitability of equivalence between the original version and the version in Portuguese. The results for most subscales were satisfactory, however, differed from other studies on the CONNECT. This study is the first phase to obtain a valid measure of continuity of care for Brazilian patients with severe mental illnesses and additional studies to examine the validity of the CONNECT still are needed.

Satisfação de familiares com o atendimento oferecido por um Centro de Atenção Psicossocial Infantojuvenil (CAPSi) da cidade do Rio de Janeiro

Introduction Family has become an active participant of the evaluation of mental health services process following the psychiatric care reform. In this context, one of the most commonly used measures to evaluate the service is satisfaction. This study aimed to evaluate a CAPSi and its relationship to sociodemographic and psychosocial aspects, among relatives of its patients. Methods Sectional epidemiological study that used: sociodemographic questionnaire, scale of stressful life events, quality of life, burden, social support and coping strategies. Results 102 families were interviewed, whose average overall satisfaction with the service was 3,9 (sd = 0,6). Satisfaction related factors were: treatment outcomes, hospitality and service competence, service privacy and confidentiality, diagnosis of autism, being female relative, less burden, better quality of life regarding physical, psychological and environmental aspects, greater material support and greater use of coping strategies focused on the problem. Conclusion The identification of factors that may influence the families satisfaction with the service, can be of great help for the construction of more adequate services to these families and patients.