Submitted by Cristiane Chim (cristiane.chim@ucpel.edu.br) on 2017-04-24T14:36:33Z No. of bitstreams: 1 Clarissa Martins.pdf: 1616707 bytes, checksum: 7d6ba6c5f2c247d0a5ccd351abde1ebe (MD5) / Made available in DSpace on 2017-04-24T14:36:33Z (GMT). No. of bitstreams: 1 Clarissa Martins.pdf: 1616707 bytes, checksum: 7d6ba6c5f2c247d0a5ccd351abde1ebe (MD5) Previous issue date: 2014-10-28 / This dissertation refers to an epidemiological study of screening scales for depression in pregnant adolescents. The main objective of the research was to adjust the cutoff scales for screening for depression, Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI), for pregnant teenagers. It is a cross-sectional, population-based study carried out with pregnant adolescents (10-19 years old), which consulted the service prenatal Unified Health System (SUS) of Pelotas. Was carried out from October 2009 to March 2011. The sample was composed based on the SIS-Prenatal program records along the municipal health department and the Basic Health Units, and specialized clinics in the urban area of Pelotas / RS. The women answered a questionnaire with socio demographic and obstetric data, besides the two scales for screening for depression during pregnancy. Also participated in a structured clinical interview Mini International Neuropsychiatric Interview 5.0 (MINI) for the clinical diagnosis of depression. Demographic, obstetric and psychiatric social variables were assessed according to the WHO questionnaire. The accuracy of the scales was calculated by their Area under the curve (AUC) of ROC, as well as their respective sensitivity, specificity and predictive values. The best cutoff (PC) found for this sample was ≥10 EPDS scale, with sensitivity 81.1% and specificity 82.7% and AUC of 0.899. BDI for the best cutoff point was ≥11, sensitivity 81.1%, sensitivity 76.8% and an AUC of 0.869. Since the difference between the two AUC were statistically significant (p = 0, 0215). Based on the results, it is concluded that the EPDS scale has become more predictive and sensitive in screening for depression in pregnant adolescents, with respect to BDI. / A presente dissertação refere-se a um estudo epidemiológico sobre escalas de rastreamento para depressão em gestantes adolescentes. O objetivo principal da pesquisa foi verificar os pontos de corte das escalas para rastreamento da depressão Edinburgh Postnatal Depression Scale (EPDS) e Beck Depression Inventory (BDI), em gestantes adolescentes. Trata-se de um estudo transversal, de base populacional, realizado com gestantes adolescentes (10 a 19 anos de idade), as quais consultaram o serviço de pré-natal do Sistema Único de Saúde (SUS) de Pelotas-RS. Desenvolvido no período de outubro de 2009 a março de 2011. A amostra foi composta com base nos registros do programa SIS-Pré-Natal, junto a secretaria municipal de saúde e nas Unidades Básicas de Saúde, além de ambulatórios especializados na zona urbana de Pelotas/RS. As gestantes responderam a um questionário com dados sócio demográfico e obstétricos, além das duas escalas para o rastreamento da depressão durante a gestação. Também participaram de uma entrevista clínica estruturada Mini Internacional Neuropsychiatric Interview 5.0 (MINI) para o diagnóstico clínico da depressão. As variáveis sócio demográficas, obstétricas e psiquiátricas foram avaliadas nos domínios do questionário da OMS. A precisão das escalas foi calculada através de suas Áreas sob a curva (AUC) de ROC, assim como suas respectivas sensibilidade, especificidade e valores preditivos. O melhor ponto de corte (PC) encontrado para esta amostra na escala EPDS foi ≥10, com sensibilidade 81,1% e especificidade 82,7% e AUC de 0,899. Para a escala BDI o melhor ponto de corte foi ≥11, sensibilidade 81,1%, sensibilidade 76,8% e uma AUC de 0,869. Sendo que a diferença entre as duas AUC mostraram-se estatisticamente significativas (p=0,0215). Com base nos resultados, conclui-se que a escala EPDS apresenta-se mais preditiva e sensível no rastreamento para depressão em gestantes adolescentes, quando contrastada com a escala BDI.

The current study examined the relationship between depression and uncertainty within the stress-diathesis model. Depression is a mental health disorder that is wide spread within our society. However, few causes of this disease have been able to be identified. Studies in uncertainty have shown that it is a major stressor in day-to-day life. Previous research has shown that individuals with high levels of uncertainty show higher levels of depression. The stress-diathesis model, a model originally developed to explain differences in development of schizophrenia, provides a theoretically meaningful way to combine these two concepts. The model states that a person who is likely to develop a disease has an internal mechanism, a diathesis, that will be triggered upon presentation of a stressor. This study tested the idea that uncertainty can be used as a stressor to activate diathesis within an individual, aiding in the prediction of depression. In total, 163 participants were randomly assigned one of three conditions, an uncertainty threat, an affirmation condition, and a control condition. Participants were given pre and post independent variable measures of depression and anxiety. Findings suggest that uncertainty activated negative emotions differentially within the participants, resulting in higher levels of negative affects after the uncertainty threat, especially for participants who already scored relatively higher on depression indicators. These results hint at a possible understanding of why depression rates and diagnosis rates of mental health issues rise during economic downturn and other times of strong uncertainty.

Magister Psychologiae - MPsych / The aim of the present study was to determine whether it was possible to identify changes in levels of postpartum depression and maternal adjustment and attitude in primiparae before and after birth. It aimed, furthermore, at assessing certain risk factors that could provide an understanding of the etiological factors (causes, determinants) influencing postpartum levels of depression and maternal adjustment and attitude. The study focused on risk factors among married and unmarried primiparae (first time mothers), with a view to establishing vulnerability profiles of the respective groups. The specific risk factors that formed part of the investigation were social support, personality (neuroticism) and life events. All the subjects investigated were recruited from the Mitchells Plain Maternity and Obstetrics Unit. A sample of 70 subjects, in the third trimester of pregnancy, voluntarily participated in the first part of this study. Of these, 26 belonged to the married group and 44 belonged to the unmarried group. As a result of the attrition factor, 57 subjects constituted the final sample for analysis. The final sample comprised 20 married and 37 unmarried subjects. Subjects were followed up four to eight weeks postpartum. Results revealed that there were no significant changes in levels of depression between the married and unmarried groups, either before or after delivery. Of significance was that with the event of birth, the depression scores amongst women rated high in neuroticism decreased significantly. Married women with high social support satisfaction scores were found to have low depression scores. Similarly, married women who experienced fewer negative life events had lower levels of depression than did the unmarried women who experienced fewer negative life events. The maternal adjustment and attitude scores did not change before or after birth, except in the married group. The married group showed a significant increase in scores on the maternal adjustment and attitude scores after the birth of the child. Regarding personality (neuroticism), the high neuroticism scorers had significantly lower maternal adjustment and attitude than did the low neuroticism scorers. As was the case with social support and depression, married women with high social support had a higher maternal adjustment and attitude. A significant effect of negative life events on maternal adjustment and attitude was only found for the married women (after delivery) who experienced a low number of life events. A stepwise multiple regression analysis was performed, in order to yield a model in which the depression and maternal adjustment and attitude scores would be predicted by risk factors. The finding of this analysis for both depression and maternal attitude and adjustment was not significant. Social Identity theory was suggested as a possible interpretation of these results. Future research which views social identity as a factor in understanding postpartum depression and maternal adjustment and attitude has been proposed .