Inácia Gomes da Silva Moraes

Prevalência da depressão pós-parto e fatores associados

OBJETIVO: Avaliar a prevalencia e os fatores associados a depressao pos-parto. METODOS: O estudo foi realizado na cidade de Pelotas, entre outubro e novembro de 2000. As maes (n=410) foram entrevistadas no hospital, utilizando dois questionarios sobre informacoes obstetricas e psicossociais. Posteriormente, as puerperas foram visitadas em casa, entre 30 a 45 dias depois do parto, quando foi aplicada a Escala de Hamilton com o objetivo de medir e caracterizar a presenca de sintomas depressivos. O teste do qui-quadrado foi utilizado na comparacao entre proporcoes e a regressao logistica nao condicional, na analise multivariada. Os dados foram analisados hierarquicamente: no primeiro nivel as variaveis socioeconomicas, no segundo, as variaveis demograficas, no terceiro, estavam as variaveis obstetricas e no ultimo nivel, as variaveis psicossociais. RESULTADOS: A prevalencia de depressao pos-parto encontrada foi de 19,1%. As variaveis renda familiar (OR=5,24; IC 95%: 2,00-13,69), preferencia pelo sexo da crianca (meninos: OR=3,49; IC 95%: 1,76-6,93) e pensar em interromper a gestacao (OR=2,52; IC 95%: 1,33-4,76), apresentaram associacao com a ocorrencia de depressao. CONCLUSOES: Os achados sugerem que baixas condicoes socioeconomicas de vida da puerpera e a nao aceitacao da gravidez sao elementos-chave no desenvolvimento da depressao pos-parto.

Depression during pregnancy in the Brazilian public health care system.

OBJECTIVE To estimate the prevalence of depression and correlate clinical and demographic characteristics in pregnant women assisted by the public health system in the city of Pelotas, RS, Brazil. METHOD We performed a cross-sectional study focused on pregnant women assisted by the public health service. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for depression. RESULTS In a sample of 1,264 pregnant women aged 12-46 years, 21.1% (n = 255) presented a depressive episode during pregnancy. The presence of depression was associated with older age, lower education, lack of a cohabiting partner, not being primiparous, planned pregnancy, abortion thoughts, psychological or psychiatric treatment, smoking and alcohol consumption during pregnancy, and stressful events. CONCLUSION Pregnant women assisted by the Brazilian public health system presented a high prevalence of depression. Psychiatric history, lack of support, and stressful events increase the probability of antenatal depression.

Sociodemographic risk factors of perinatal depression: a cohort study in the public health care system

OBJECTIVE To assess the sociodemographic risk factors for the prevalence and incidence of relevant postpartum depressive symptoms. METHOD We studied a cohort of women in their perinatal period with the assistance of the public health system in the city of Pelotas-RS, Brazil. We assessed depressive symptoms with the Edinburgh Postnatal Depression Scale (EPDS) in the prenatal and postnatal periods. RESULTS We interviewed 1,109 women. The prevalence of meaningful depressive symptoms during pregnancy was 20.5% and postpartum was 16.5%. Women with prenatal depression were at higher risk for postpartum depression. CONCLUSION The mothers poverty level, psychiatric history, partner absence and stressful life events should be considered important risk factors for relevant postpartum depressive symptoms.

Dispepsia funcional e depressão como fator associado

AIM To assess the association between depression and functional dyspepsia. PATIENTS AND METHODS Three hundred and forty eight dyspeptic patients were included in a cross-sectional study in the gastroenterology outpatient clinic of a University Hospital in southern Brazil (Pelotas, RS) within a 1-year period (from March, 2001 to March, 2002). The assessment of depression occurred after the diagnosis of dyspepsia. The presence (or not) of depression was verified in both functional and organic dyspeptic patients. In a second moment, the results were compared, an univariate analysis was used to describe the frequencies of the interest variables and a chi-square for the comparison between proportions of the categorical variables. The logistic regression technique was used to establish the odd of functional dyspeptic patients to present depression and to control the effect of other variables in the outcome variable RESULTS Showed greater prevalence of depression among functional dyspepsia patients (30,4%), when compared to organic dyspepsia patients (11,2%). Women showed greater risk to present functional dyspepsia (OR: 1,74, IC 95%, 1,05-2,89) and in terms of age, the group with ages between 31 to 50 years (OR: 0,28 IC 95%, 0,13-0,54) and 51 to 60 years (OR: 0,41, IC 95%, 0,17-0,96) showed protection effect (subjects within this age groups have minor risk to present functional dyspepsia). After the multivariate analysis depressed patients showed three times greater comorbidity with functional dyspepsia when compared to non-depressed patients (OR 3, 13; IC 95%; 1, 71-5, 74). DISCUSSION The adjustment for the gender, age and marital status variables confirmed the association between functional dyspepsia and depression. Results point the need to assess the presence of depression in functional dyspepsia patients and to establish specific treatment strategies for these patients.

Transtornos mentais comuns e auto-estima na gestação: prevalência e fatores associados

The aim of this study was to assess the prevalence of common mental disorders and the association with self-esteem and other factors in pregnant women. A nested cross-sectional study was performed in a cohort of pregnant women treated in the public health system in Pelotas, Rio Grande do Sul State, Brazil. The Self-Reporting Questionnaire (SRQ-20) was used to screen for common mental disorders and the Rosenbergs Self-Esteem Scale for self-esteem. The sample consisted of 1,267 pregnant women with a mean age of 25 years (SD = 6.53). Mean self-esteem was 9.3 points (SD = 4.76), and prevalence of common mental disorders was 41.4%. Lower self-esteem was associated with higher odds of common mental disorders (p < 0.001). There was a significant association between higher prevalence of common mental disorders and low self-esteem.

Auto-estima e fatores associados em gestantes da cidade de Pelotas, Rio Grande do Sul, Brasil

This study analyzes self-esteem and associated factors in pregnant women treated by the Unified National Health System (SUS) in the city of Pelotas, Rio Grande do Sul State, Brazil. Using a cross-sectional design, 560 pregnant women were interviewed from May to November 2006. The interviews were held in specific locations like University outpatient clinics and hospital wards and a center run by the city government. A full 62.9% were diagnosed as high-risk pregnancies. Mean self-esteem according to the Rosenberg scale was 9.2 (SD = 4.6). Variables showing a positive, significant association with self-esteem were age, schooling, and income. Perception of risk to the unborn infants health and parity were both negatively associated with maternal self-esteem. These high-risk pregnant women also showed higher self-esteem than low-risk pregnant women.

Tobacco smoking and depression during pregnancy

OBJETIVOS: Avaliar a associacao entre consumo de cigarros e depressao durante a gravidez e identificar fatores associados. METODO: Trata-se de estudo transversal, que incluiu uma populacao de 1.264 gestantes atendidas nos servicos de maior fluxo do Sistema Unico de Saude (SUS) da cidade de Pelotas (RS), Brasil. A depressao foi avaliada utilizando a Edinburgh Postnatal Depression Scale, e o consumo de tabaco foi verificado atraves de questoes abertas. Na analise estatistica, utilizou-se a regressao de Poisson. RESULTADOS: A prevalencia de depressao durante a gestacao foi de 21,2%; 19,3% das gestantes com depressao eram fumantes. As mulheres que fumaram durante a gravidez apresentaram 1,72 (intervalo de confianca de 95%: 1,27-2,34) maior probabilidade de ter depressao. CONCLUSAO: Os resultados indicam uma relacao positiva entre o consumo de cigarros durante a gravidez e episodios depressivos.

Reply to Faisal-Cury et al.'s letter: "Depression during pregnancy in the Brazilian public health care system"

, ja aprovado no periodico Cadernos de Saude Publica e que aguarda publicacao. Entretanto, nao foi incluido em nossa revisao, nem o consideramos um estudo antecedente ao nosso presente artigo, uma vez que seu estudo apresenta uma diferente medida de avaliacao e desfecho. O estudo de Faisal-Cury utilizou uma entrevista clinica que tem por objetivo avaliar sintomas psiquiatricos em seu conjunto (transtornos mentais), que incluem inquietacao, irritabilidade, ansiedade, preocupacao somatica, problemas do sono e da concentracao, fadiga, humor depressivo, comportamento compulsivo e obsessivo, hipocondria, fobias e pânico, agrupados em TMC. A investigacao verificou os fatores associados a este conjunto, enquanto nosso estudo verificou fatores associados especificamente o quadro de depressao gestacional, por meio da