Paulo Luis Rosa Sousa

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.

Relação entre bem-estar espiritual e transtornos psiquiátricos menores: estudo transversal

OBJECTIVE To assess the influence of spiritual well-being in mental health of college students. METHODS It was interviewed 464 medical and law students of Pelotas, Brazil. Data collection was carried out in groups in the school classroom, 43 absent students were not interviewed and represented a loss of 9.3% of the sample. It was used a self-reported questionnaire with three instruments: 1) Spiritual Well-Being Scale (SWBS), 2) SRQ-20, and 3) a precoded questionnaire with questions on sociodemographic data, religious/spiritual practices, and stressful life events. Statistical analysis was performed using Chi-square test and logistic regression. RESULTS Most of the students (80%) declared that they had a spiritual belief and/or religious denomination. The mean score of spiritual well-being was 90.4 with scores 45.6 and 45.1 in the existential and religious subscales, respectively. SWBS showed an association with religious practices, but it was not influenced by sociodemographic and cultural variables. Subjects presenting low and moderate spiritual well-being showed a doubled risk of presenting minor psychiatric disorders (MPD) (OR=0.42; 95%CI: 0.22-0.85). Subjects presenting low or moderate existential well-being showed almost five times more MPD (OR=0.19; 95%CI: 0.08-0.45). CONCLUSIONS The study reveals spiritual well-being as a protection factor for minor psychiatric disorders, and that the results were mostly due to the Existential Well-Being subscale.

Bem-estar espiritual e transtornos psiquiátricos menores em estudantes de psicologia: estudo transversal

INTRODUCAO: Religiosidade/espiritualidade e saude mental parecem positivamente associadas. O estudo examina associacoes entre bem-estar espiritual e disturbios psiquiatricos menores em estudantes de Psicologia. METODOS: Uma escala de bem-estar espiritual, o Self-Reporting Questionnaire (SRQ-20) e informacoes sociodemograficas foram utilizadas na totalidade (n = 351) dos alunos de Psicologia da Universidade Catolica de Pelotas (RS), no ano de 2002. Foram comparados os escores atuais com os dos alunos de Direito e Medicina da mesma universidade em 2001 (n = 464). RESULTADOS: 84,6% dos alunos de Psicologia apresentaram espiritualidade negativa, comparados a 68,8% dos academicos de Medicina e 68,5% de Direito (p DISCUSSAO: Os achados coincidem com a experiencia internacional. E preocupante que estudantes de Psicologia se mostrem mais distantes de questoes espirituais/religiosas, levando em conta a associacao espiritualidade/saude-enfermidade. CONCLUSAO: A religiosidade/espiritualidade se mostrou como fator inversamente associado a transtornos psiquiatricos menores em estudantes de Psicologia.INTRODUCTION: Religiosity/spirituality and mental health seem to be positively associated. This study examines associations between spiritual well-being and psychiatric disorders in psychology students. METHODS: A spiritual well-being scale - the self-reporting questionnaire (SRQ-20) - and sociodemographic information were used to all psychology students (n = 351) from Universidade Catolica de Pelotas, RS, Brazil, during the year of 2002. Current scores were compared to those obtained from medical and law students of the same university in 2001 (n = 464). RESULTS: 84.6% of psychology students presented negative spirituality, compared to 68.8% of medical and 68.5% of law students (p DISCUSSION: The findings coincide with the international experience. It is a matter of concern that psychology students define themselves more distant from spiritual/religious issues, considering the association spirituality/health-illness. CONCLUSION: Spirituality-religiosity appeared as a factor inversely associated to minor psychiatric disorders among psychology students.

High Prevalence of Depression amongst Mothers of Children with Asthma

Objective. To compare the prevalence of depression among mothers of children with asthma and mothers of children without asthma and to investigate the influence of severity and duration of childhood asthma on maternal depression. Method. A cross-sectional study including 80 mothers of children with asthma and 160 mothers of children without asthma who attended the pediatric outpatient clinics of a teaching hospital in Southern Brazil. The main outcome measure was the presence of depression in these mothers, measured by the Beck Depression Inventory. Results. The prevalence of depression was higher among mothers of asthmatic children compared with mothers of non-asthmatic children (43.8% vs. 17.5%, p < 0.001), with an adjusted prevalence ratio of 2.74 (95% confidence interval [CI] 1.76–4.25). Mothers of children with persistent asthma had a higher prevalence of depression than mothers of children with intermittent asthma (62.8% vs. 21.6%, p < 0.001), with an adjusted prevalence ratio of 2.77 (95% CI: 1.46–5.27). No significant association was observed between duration of childhood asthma and maternal depression. Conclusion. Mothers of children with asthma have a higher prevalence of depression than mothers of children without asthma. The severity but not duration of childhood asthma is associated with maternal depression.

Cocaine Addiction and Family Dysfunction: A Case-Control Study in Southern Brazil

Family-related factors play a crucial role in the onset, development, and maintenance of drug misuse and addiction. To investigate the hypothesis that families with a cocaine addicted son display more dysfunction than control families, we applied the Personal Authority in the Family System and the Self-Report Measure of Family Functioning to 67 case triads (child–father–mother) in which the son was an inpatient with a primary diagnosis of cocaine abuse or dependence and to 67 matched control triads from the community (Pelotas, Brazil) in 2000. Case children, mothers, and fathers were significantly more likely to present nuclear family triangulation than their matched control subjects. In addition, case triads had a significantly greater chance of perceiving family functioning as enmeshment. These results suggest both structural and functional differences in these families. We argue for the need of interventions in the family as a whole and for further research in this area.

Cocaine addicts and their families. An empirical study of the processes of identification.

The processes of identification between adolescent cocaine addicts and their parents were studied in 402 subjects, in total 134 familial triads (father“mother”son), subdivided into two groups of 67 triads, one of these groups having as the child an adolescent of masculine sex dependent on cocaine and the other, equal in number, being a control group, duly matched for age and socio‐economic status. The instrument employed was the Rorschach test (1922), limited to the application of the Lerner Defense Scale (LDS; Lerner & Lerner, 1980). The findings in the affected triads showed up as consistent statistically for the presence of intense processes of pathological identification, especially between father and son, a sign of the importance of the presence of disturbances of paternal function in the development of this addiction. The utilisation of very regressive defence mechanisms, above all of projective identification, was the predominant mode of procedure in triads with a dependent child. In comparisons between the fathers the odds ratio (OR) for projective identification was 8.66 to 1, which points to the association between cocaine addiction and the primitive mental functioning of the fathers. With empirical methodology these findings serve to corroborate the psychoanalytical conclusions based on studies of single case studies, testifying that the dysfunctions of identificatory phenomena in familial functioning are predominant in the mental organisation of cocaine addicts.

Questions about questions: New views on an old prejudice

The belief that good analysts do not ask, and do not answer, questions is a still‐living strange recommendation, transmitted throughout psychoanalytic generations. The authors have extensively reviewed electronic databases and technical texts. They found that interrogative acts are largely omitted from technical considerations, generating a prejudice that does not consider questions as proper psychoanalytic tools, and they discuss possible foundations for this belief. The authors believe that the few authors that have touched on this issue have done so in a non‐systematic and frequently incomplete form. Linguistic philosophy presents questions as speech acts: actions that are able to alter the equilibrium of dialogical discourses. This view permits psychoanalysts to understand the potentiality of questions to introduce psychic change because they can, simultaneously, interfere in the self, in the other and in the intersubjective relationship. An internal state of curiosity is described as a component of the mind of the analyst. Based on the argument of the ubiquity of the state of curiosity of the analyst, the authors carried out a set of technical propositions, regarding, on the one hand, when questions are not to be introduced (for instance, in the presence of free associations) and, on the other hand, when they would be useful as expanding factors of the preconscious‐conscious system. Considering psychoanalyses as experiences of curiosity, they emphasize that both the internal state of curiosity of the analyst, and the eventual verbal questions put to the patient are potentially positive factors for psychic change. The authors present several clinical vignettes.

Spiritual well-being and minor psychiatric disorders in psychology students: a cross-sectional study

INTRODUCAO: Religiosidade/espiritualidade e saude mental parecem positivamente associadas. O estudo examina associacoes entre bem-estar espiritual e disturbios psiquiatricos menores em estudantes de Psicologia. METODOS: Uma escala de bem-estar espiritual, o Self-Reporting Questionnaire (SRQ-20) e informacoes sociodemograficas foram utilizadas na totalidade (n = 351) dos alunos de Psicologia da Universidade Catolica de Pelotas (RS), no ano de 2002. Foram comparados os escores atuais com os dos alunos de Direito e Medicina da mesma universidade em 2001 (n = 464). RESULTADOS: 84,6% dos alunos de Psicologia apresentaram espiritualidade negativa, comparados a 68,8% dos academicos de Medicina e 68,5% de Direito (p DISCUSSAO: Os achados coincidem com a experiencia internacional. E preocupante que estudantes de Psicologia se mostrem mais distantes de questoes espirituais/religiosas, levando em conta a associacao espiritualidade/saude-enfermidade. CONCLUSAO: A religiosidade/espiritualidade se mostrou como fator inversamente associado a transtornos psiquiatricos menores em estudantes de Psicologia.INTRODUCTION: Religiosity/spirituality and mental health seem to be positively associated. This study examines associations between spiritual well-being and psychiatric disorders in psychology students. METHODS: A spiritual well-being scale - the self-reporting questionnaire (SRQ-20) - and sociodemographic information were used to all psychology students (n = 351) from Universidade Catolica de Pelotas, RS, Brazil, during the year of 2002. Current scores were compared to those obtained from medical and law students of the same university in 2001 (n = 464). RESULTS: 84.6% of psychology students presented negative spirituality, compared to 68.8% of medical and 68.5% of law students (p DISCUSSION: The findings coincide with the international experience. It is a matter of concern that psychology students define themselves more distant from spiritual/religious issues, considering the association spirituality/health-illness. CONCLUSION: Spirituality-religiosity appeared as a factor inversely associated to minor psychiatric disorders among psychology students.

Bienestar espiritual y trastornos psiquiátricos menores en estudiantes de psicología: estudio transversal

INTRODUCAO: Religiosidade/espiritualidade e saude mental parecem positivamente associadas. O estudo examina associacoes entre bem-estar espiritual e disturbios psiquiatricos menores em estudantes de Psicologia. METODOS: Uma escala de bem-estar espiritual, o Self-Reporting Questionnaire (SRQ-20) e informacoes sociodemograficas foram utilizadas na totalidade (n = 351) dos alunos de Psicologia da Universidade Catolica de Pelotas (RS), no ano de 2002. Foram comparados os escores atuais com os dos alunos de Direito e Medicina da mesma universidade em 2001 (n = 464). RESULTADOS: 84,6% dos alunos de Psicologia apresentaram espiritualidade negativa, comparados a 68,8% dos academicos de Medicina e 68,5% de Direito (p DISCUSSAO: Os achados coincidem com a experiencia internacional. E preocupante que estudantes de Psicologia se mostrem mais distantes de questoes espirituais/religiosas, levando em conta a associacao espiritualidade/saude-enfermidade. CONCLUSAO: A religiosidade/espiritualidade se mostrou como fator inversamente associado a transtornos psiquiatricos menores em estudantes de Psicologia.INTRODUCTION: Religiosity/spirituality and mental health seem to be positively associated. This study examines associations between spiritual well-being and psychiatric disorders in psychology students. METHODS: A spiritual well-being scale - the self-reporting questionnaire (SRQ-20) - and sociodemographic information were used to all psychology students (n = 351) from Universidade Catolica de Pelotas, RS, Brazil, during the year of 2002. Current scores were compared to those obtained from medical and law students of the same university in 2001 (n = 464). RESULTS: 84.6% of psychology students presented negative spirituality, compared to 68.8% of medical and 68.5% of law students (p DISCUSSION: The findings coincide with the international experience. It is a matter of concern that psychology students define themselves more distant from spiritual/religious issues, considering the association spirituality/health-illness. CONCLUSION: Spirituality-religiosity appeared as a factor inversely associated to minor psychiatric disorders among psychology students.