Joana Prata

Bone mineral density and depression: a community study in women.

In a community sample of 102 Portuguese white women we evaluated the relationship between osteoporosis and indexes of psychopathology and well-being. Depressive symptoms were assessed by the Beck Depression Inventory (BDI), psychopathology by the Hopkins Symptom Checklist-90 Revised (SCL-90-R), and quality of life using the Psychological General Well-Being Index. A questionnaire comprising social, demographic, clinical, and behavioral characteristics was also used. The sample prevalence of osteoporosis was 47.1%. Women with osteoporosis presented significantly higher scores on the total BDI (16+/-9 vs. 13+/-10, p=0.045) and lower scores in the hostility (0.8+/-0.6 vs. 1.2+/-0.7, p=0.012) and phobic anxiety (1.1+/-0.8 vs. 1.5+/-0.9, p=0.041) subscales of the SCL-90-R. No differences were found regarding mean general well-being scores (62+/-17 vs. 64+/-19, p=0.665). This study showed that women with osteoporosis have significantly higher levels of depressive symptoms and a corresponding higher prevalence of depression, independent of other factors strongly associated with osteoporosis, such as age or body mass index.

Depression and the Severity of Substance Abuse

Background: Psychosocial factors have been considered important in the initiation of drug abuse and seem to affect its clinical course and outcome. Several studies have reported psychopathology, namely depression, to be consistently high in addiction. The aim of this investigation was to evaluate the prevalence of depression and its relationship to the severity of drug abuse in a Portuguese sample of drug addicts. Methods: Two hundred and eighty-five drug addicts (23 women and 262 men, aged between 16 and 41 years old), diagnosed according to the DSM-IV criteria, were contacted during their first visit for treatment at public health centres. Social, demographic and behavioural characteristics of the study sample were obtained by interview using a structured questionnaire. The severity of drug abuse was evaluated using a Portuguese version of the Drug Abuse Screening Test, and depression was assessed by the Zung self-rating depression scale. Results: The prevalence of depression was 51.2% and was higher in females than males (77.8 vs. 48.7%, p = 0.034). A significant correlation was also found between the severity of drug abuse and depression scores, which was also stronger in females (r = 0.53 vs. r = 0.24). Conclusions: This study showed a high prevalence of depression in drug addicts, regardless of the type and duration of drug abuse, and a significant association between depression and severity of drug addiction.

Psychosocial indexes and cardiovascular risk factors in a community sample.

Background: Psychosocial characteristics might contribute to a more comprehensive understanding of cardiovascular disease as it is increasingly recognised that biomedical risk factors do not fully explain its dynamics. This study aimed to describe psychometric indexes in a Portuguese community sample relating them to known cardiovascular disease risk factors. Methods: Anthropometric, blood pressure, serum measurements and information on demographic, social, medical and behavioural characteristics were obtained for 215 women and 156 men. Self-administered questionnaires were used for the psychometric evaluation (Bortner scale, Beck Depression Inventory, Hopkins Symptom Distress Checklist 90-Revised, Psychological General Well-Being and the Nottingham Health Profile, NHP). Results: There were significant differences according to gender regarding almost every psychometric dimension assessed. After adjusting for the presence of different biomedical risk factors, significant decreasing mean behaviour pattern scores were found with increasing age. Mean depression scores were significantly higher in women and in individuals with lower educational level. As to general psychological well-being, the highest scores were obtained for men and individuals with higher educational level. For the assessed dimensions of quality of life, as well as indexes of psychopathology, men scored better than women. No significant differences in mean scores of behaviour pattern, depression, psychological general well-being and dimensions of NHP were found according to the presence of an increasing number of cardiovascular risk factors. Conclusions: The study shows that the clustering of multiple biomedical risk factors does not result in additive deleterious psychological effects and that psychometric indexes are mainly dependent on gender and education, common confounders in most studies evaluating cardiovascular risk factors.

Differences in behavior profile between normotensive subjects and patients with white-coat and sustained hypertension

It has been hypothesized that white-coat hypertensives (WCHs) have lower cardiovascular risk than sustained hypertensives (HTs), but higher emotional reactivity. We evaluated 92 HT patients (clinic and daytime BP>140/90 mmHg), 52 WCHs (clinic BP>140190 and ambulatory daytime BP<134/ 85 mmHg), and 74 normotensive subjects (NTs, clinic BP<140/90 and ambulatory daytime BP<134/85 mmHg), aged between 24 and 72 years, and matched for educational level, age, gender, and weight for depression, psychopathology, well-being, and quality of life. HTs showed worse scores than WCHs and NTs on most of the psychological variables; no differences were found between WCHs and NTs except on physical mobility. Daytime BP variability was HTs>WCHs>NTs, whereas nighttime BP variability was HTs>WCHs=NTs. We conclude that HTs have worse psychological profiles than the other two groups. WCHs and NTs have similar psychological profiles, although WCHs have a higher daytime BP variability, which is not associated with higher emotional reactivity.

Acute Myocardial Infarction: Psychosocial and Cardiovascular Risk Factors in Men:

Background Controversy still exists over the independent role of psychosocial factors in acute myocardial infarction (AMI). This study aimed to compare psychometric indices in Portuguese patients surviving a first episode of AMI and a community sample free of AMI. Design A community-based, case–control study. The study sample included 153 male patients with a first episode of AMI and 156 male controls randomly selected from the community. Methods Information on demographic, social, medical and behavioural characteristics was obtained using a structured questionnaire; anthropometric, blood pressure, and serum measurements were performed, and the psychometric evaluation was obtained using a self-evaluation questionnaires (Bortner scale, Beck Depression Inventory, SCL-90-R, Psychological General Well-Being and the Nottingham Health Profile). Results Cases of AMI more often exhibited type A behaviour (15.4 ±3.0 versus 14.7 ±2.7, P = 0.041), had more depressive symptoms (10.8 ±8.0 versus 8.6 ±8.0, P = 0.005) and showed worse scores on general well-being (68.4 ± 17.7 versus 76.6 ± 16.2, P < 0.001) than controls. Cases were significantly different from controls in terms of years of education (6.7 ±4.4 versus 9.0 ± 4.7 years, P < 0.001), hypertension (43.1% versus 30.1%, P = 0.024), dislipidaemia (43.8% versus 34.0%, P = 0.038), type I obesity (53.6% versus 42.3%, P = 0.045), smoking (54.1% versus 26.5%, P < 0.001), no practise of exercise (68.5% versus 50.3%, P = 0.002) and presence of non-insulin-dependent diabetics (16.3% versus 6.4%, P = 0.010). After adjusting for such factors a similar set of significant psychometric results was found. Conclusion Type A behaviour, depression and lower levels of well-being and quality of life, independent of other cardiovascular risk factors, were significant features of AMI cases.

Bridging Autism Spectrum Disorders and Schizophrenia through inflammation and biomarkers - pre-clinical and clinical investigations

In recent years, evidence supporting a link between inflammation and neuropsychiatric disorders has been mounting. Autism spectrum disorders (ASD) and schizophrenia share some clinical similarities which we hypothesize might reflect the same biological basis, namely, in terms of inflammation. However, the diagnosis of ASD and schizophrenia relies solely on clinical symptoms, and to date, there is no clinically useful biomarker to diagnose or monitor the course of such illnesses.The focus of this review is the central role that inflammation plays in ASD and schizophrenia. It spans from pre-clinical animal models to clinical research and excludes in vitro studies. Four major areas are covered: (1) microglia, the inflammatory brain resident myeloid cells, (2) biomarkers, including circulating cytokines, oxidative stress markers, and microRNA players, known to influence cellular processes at brain and immune levels, (3) effect of anti-psychotics on biomarkers and other predictors of response, and (4) impact of gender on response to immune activation, biomarkers, and response to anti-psychotic treatments.

Depression predicts mortality and hospitalization in heart failure: A six-years follow-up study.

BACKGROUND The aim of this study is to evaluate the prevalence of depressive symptoms (DS) and its relation on hospitalization for cardiovascular (CV) causes and all-cause mortality risk among outpatients with HF. METHODS A prospective study was conducted on 130 adult outpatients with HF. The Beck Depression Inventory Scale-second edition (BDI-II) was used to screen for DS. All-cause mortality and hospitalization for CV causes were registered over 6 years. Logistic regression and multinomial logistic regression analysis were used to evaluate the independent prognostic value of DS on mortality and hospitalization for CV causes after adjustment for clinical risk factors. RESULTS During a mean follow-up of 6 years, 44% of patients were classified as having DS. Sixty-two participants died for all causes, representing 61% of those with DS and 37% of those without (p=0.006); Forty-nine participants (38%) were hospitalized for CV causes, representing 49% of those with DS and 29% of those without (p=0.027). Logistic regression analysis indicated that DS predicted all-cause mortality (OR: 2.905; 95% CI:1.228-6.870; p=0.006) and multinomial logistic regression indicated that DS were predictive of hospitalization for CV causes (OR: 3.169; 95% CI: 1.230-8.164; p=0.027). These associations were independent of conventional risk factors. LIMITATIONS Only outpatient sample; measure of DS only at baseline; cause of death was not known. CONCLUSION This study, first held in a portuguese population, showed that DS are independent predictors of death and hospitalization for CV causes among HF patients and its impact persists over 6 years.

Women with coronary artery disease: do psychosocial factors contribute to a higher cardiovascular risk?

Despite the mortality and morbidity burden associated with cardiovascular disease in women, there is insufficient knowledge regarding gender specificities in both biomedical and psychosocial domains. Gender differences in both pathophysiology and biological risk factors might explain distinct prevalence rates, symptom profiles, and even medical outcomes, but gender-related specificities regarding psychosocial risk factors might further explain this. The authors review the key issues on this topic and outline suggestions for future research. Ultimately, a better understanding of this matter will translate not only into improved clinical management of female patients, but also gender-specific strategies in the prevention of cardiovascular disease.

Microplastics in wastewater: State of the knowledge on sources, fate and solutions

Microplastics are ubiquitous contaminants that could harm ecosystems. Wastewater contains microplastics and may lead to further contamination of the environment. This focus article presents a summary of current knowledge on microplastics in wastewater and possible solutions, suggesting current research needs.

Gender differences in quality of life perception and cardiovascular risk in a community sample.

INTRODUCTION Self-reported heath and quality of life is an independent predictor of overall and cardiovascular morbidity and mortality, and incident coronary heart disease. However, less is known regarding how gender differences in cardiovascular risk factors impact quality of life perception. METHODS Primary healthcare users (n=261, 158 women) were screened for cardiovascular risk factors and completed the Medical Outcomes Study Short Form (SF-36). RESULTS Women had significantly lower alcohol consumption, body mass index and exercise frequency than men, but more prevalent psychiatric history, depressive and anxiety symptoms, and negative affectivity. Prevalences of hypertension, diabetes, dyslipidemia and type D personality were similar between genders. Women reported significantly worse quality of life on most SF-36 subscales and gender differences were apparent in predictors of quality of life. Moreover, high negative affectivity was an independent predictor of worse general health for women, whereas high social inhibition and high anxiety had a comparable role for men. CONCLUSION Gender specifics in cardiovascular risk factors should be considered in prevention strategies. Women reported significantly worse quality of life, putting them at higher risk for cardiovascular morbidity and mortality. Therefore, gender differences in predictors of quality of life warrant further investigation.