This study utilized data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) at two different time points, seven years apart, to examine the relationship between physical illness and depressive symptoms in elderly Mexican Americans. The two physical illnesses studied are coronary artery disease and type II diabetes due to their high prevalence among Mexican Americans. The relationship between physical illness and depressive symptoms is examined longitudinally and prospectively, in both directions. In addition, the relationship between depressive symptoms and three behavioral health risk factors: alcohol use, cigarette smoking, and physical inactivity, at baseline is examined. The roles of gender, acculturation, nativity, and locus of control are examined as moderators of the key relationships studied. Additionally, self-rated health at baseline is examined as a predictor of physical illness and mortality at follow-up. / text

Research suggests that depressive symptoms and financial stress are both associated with increased levels of cigarette smoking, yet not every individual who experiences depressive symptoms or financial stress smokes. The primary purpose of this study was to examine whether positive and negative religious coping moderated the influence of depressive symptoms and financial stress on current (past 30-day) cigarette smoking over and above the contributions of demographic covariates and nonreligious problem- and emotion-focused coping. Participants were drawn from a larger study comprised of a convenience sample of 1,120 post-secondary vocational/technical school students enrolled in programs such as welding, air-conditioning, and vocational nursing at two different two-year public colleges in Texas. These students are training to work in blue-collar occupations, which have higher smoking rates compared to white-collar occupations. Negative binomial regression analysis was used to test the study hypotheses. Depressive symptoms and financial stress increased the likelihood of smoking for female students, whereas financial stress decreased the likelihood of smoking for male students. Positive religious coping decreased the likelihood of smoking for females only. Consistent with religious coping theory and as expected, negative religious coping moderated the depressive symptoms-smoking relationship such that negative religious coping exacerbated the impact of depressive symptoms on cigarette smoking among females. Positive religious coping also moderated the depressive symptoms-cigarette smoking relationship for females. Contrary to expectations, positive religious coping exacerbated the likelihood of cigarette smoking among females with high levels of depressive symptoms. Negative religious coping moderated the financial stress-cigarette smoking relationship such that males who reported low financial stress and high levels of negative religious coping had the highest likelihood of smoking in the past month. For females, religious coping was associated with current cigarette use, but did not moderate the association between financial stress and smoking. Even after controlling for demographic covariates and nonreligious coping, positive and negative religious coping influenced the smoking behaviors of vocational students experiencing depressive symptoms and financial stress, and these outcomes varied by gender. Study limitations, implications, and suggestions for future directions in research are discussed. / text

Depression- och ångestsymtom, som kan beskrivas som en del av emotionell ohälsa, är ett frekvent och växande problem inom den svenska ungdomspopulationen. Både en hög komorbiditet samt könsskillnader i ohälsa kan observeras. Samband mellan emotionsreglering och ohälsa har under senare år erhållit ett brett empiriskt stöd. Denna longitudinella studie syftade till att undersöka emotionsreglerings roll som mediator i utvecklandet av emotionell ohälsa över tid samt om det eventuella sambandet modereras av kön. Analyser visade att emotionsreglerings-strategierna kognitiv emotionsreglering och beteendemässigt undvikande medierade sambandet. Detta skiljde sig även åt mellan könen vad gäller kognitiv emotionsreglering. Utifrån studiens resultat dras slutsatsen att emotionsreglering kan utgöra en del av förklaringen av ökad emotionell ohälsa över tid hos ungdomar. Detta samband tycks även vara mer gällande för flickor. / Depressive and anxiety symptoms, which can be classified as types of emotional distress, anre common and growing issues among Swedish youth. Substantial comorbidity and gender differences concerning emotional distress have been observed. The relationship between emotion regulation and emotional distress have obtained convincing empirical support during the last couple of decades. This longitudinal study aimed to investigate the mediating role of emotion regulation in the development of emotional distress over time. The question of gender as a moderator of the relationship was also addressed. Analysis indicate that two emotion regulation strategies, cognitive emotion regulation and behavioral avoidance, do mediate the relationship. Gender differences were found in the cognitive strategy. The results of the study indicate that emotion regulation could be a part of the explanation for the increase of adolescent emotional distress over time. This relationship also seem to be more distinct for girls.

Acculturation is a predominant feature of today’s society and one that has unique implications for immigrants’ mental health. Given that two thirds of Canada’s population growth is due to immigration, understanding the effects of acculturation on newcomers should be a central focus of academic research. The present study utilized an exploratory quantitative method to investigate the associations between acculturation strategies, quality of life, and negative affect in a sample of 180 Brazilian immigrants living in the Greater Toronto Area. The mediating and moderating roles of quality of life (QOL) were explored, as well as which patterns of acculturation strategies were associated with enhanced well-being, represented by low negative affect (NA), high QOL, and high Satisfaction with Life in Canada (SLCI). Clusters analysis identified patterns of acculturation strategy use, resulting in four acculturation profiles: integrated, assimilated, separated, and marginalized. Results indicated that QOL did not act as either a mediator or moderator of the relationship between acculturation profiles and NA. With regard to well-being indicators, acculturation profiles successfully predicted NA and SLCI, with the Assimilated being the most favourable profile evidenced by its lowest NA and highest SLCI levels. While acculturation profiles did not predict QOL, the trend of the Assimilated profile being predictive of favourable well-being was also present as its members reported slightly higher QOL than their counterparts from other profiles. Well-being risk and protective factors are presented. The results highlight the importance of including control variables in future research in order to uncover the unique impact of acculturation on the mental health of immigrants. Implications for practice and future research are also discussed.

Young adulthood is a critical period during which advances in educational, occupational, and financial adjustment set the stage for lifelong economic capital, health, and well-being. Greater understanding of the factors that contribute to positive and negative adjustment in young adulthood is warranted. This longitudinal study highlights the important role of parents by investigating (1) changes in the emotional quality of parent-youth relationships during adolescence and the transition to adulthood, (2) whether such changes relate to young adults’ adjustment outcomes in three age-salient domains, and (3) whether the effects of changes in parental relationships are associated with young adults’ adjustment outcomes through the intervening effects of mental health symptoms. Specifically, I examined direct and indirect associations between changes in mother and father emotional support (ES) and psychological control (PC) and young adults’ educational, occupational, and financial outcomes through youths’ depressive and anxiety symptoms. Sex and SES group differences were also examined. Participants were 545 youth from a medium-sized Canadian city. They were assessed at four time points over a six-year period. All analyses were conducted separately by two developmental transition groups: The young adult transition group included 240 participants who were initially 18 to 21 years old, and the adolescent transition group included 305 participants who were 14 to 17 years old at the initial assessment. Measures of parental ES and PC, youth’s mental health symptoms, and youth’s adjustment were obtained through self-reports. Multi-level modeling analyses showed that mother and father ES increased over time for both transition groups. Declines in mother and father PC were significantly greater for the young adult transition group. Results from latent growth curve mediation analyses revealed that parental ES was linked to positive and negative youth adjustment directly and indirectly through depressive symptoms. Findings also highlight the negative effects of parental PC on youth’s adjustment outcomes directly and also indirectly through changes in youth’s depressive and anxiety symptoms. Differences for mothers and fathers, males and females, and lower and higher SES groups are discussed. Overall, the quality of parent-youth relationships changes during the transition to adulthood, and such changes are important factors in understanding young adults’ educational, occupational, and financial adjustment. / Graduate / 0620

Base teórica: A qualidade de vida é uma variável amplamente estudada nas ciências da saúde e tem se tornado, cada vez mais, um indicativo importante na avaliação dos estados e desfechos de saúde. As doenças crônicas se caracterizam por curso prolongado, por vezes acompanhando o portador por toda sua vida, o que pode influenciar a percepção que o indivíduo tem de si mesmo e de sua vida. A Neurofibromatose tipo 1 (NF1) é uma doença crônica, genética, que atinge cerca de 1:3500 nascimentos. Além de ser uma doença que acarreta uma maior predisposição ao desenvolvimento de tumores, a NF1 possui sintomas físicos de fácil identificação. Objetivo: O presente estudo visa estudar a qualidade de vida e algumas variáveis emocionais de pessoas com neurofibromatose tipo 1. Método: Trata-se de um estudo transversal. Foram avaliadas as variáveis de qualidade de vida genérica (WHOQOL-bref e SF-36), qualidade de vida específica para pessoas com problemas de pele (DLQI-bra), sintomas depressivos (BDI), sintomas de ansiedade(BAI), percepção de suporte familiar (IPSF) e estratégias de enfrentamento (Inventário de Estratégias de Coping de Folkman e Lazarus). Os participantes deste estudo também foram avaliados quanto à gravidade (Escala de Riccardi) e visibilidade dos sintomas da doença (Ablon). Resultados: Foram coletados dados de 71 pacientes adultos com NF1. Do total 60,0% da amostra foram pessoas do sexo feminino, a média de idade foi de ± 40,36 anos. Dos 52 pacientes avaliados pela escala de Riccardi, 11,3% apresentou gravidade leve, 40,4% gravidade moderada, 42% sintomas graves de gravidade e 6,5% sintomas muito graves da doença. Com relação a visibilidade dos sintomas medidos pela escala de Ablon, 36,5% apresentam visibilidade leve de sintomas, 30,8% visibilidade moderada e 32.7% visibilidade severa dos sintomas. Conclusão: Os resultados da avaliação de qualidade de vida de pessoas com NF1, ao serem comparados com os dados normativos para amostra, não apresentou diferença estatisticamente significativa. A análise dos sintomas depressivos indicou que grande parte dos entrevistados apresentam sintomas leves de depressão e os dados da escala BAI referente aos sintomas de ansiedade constatou que a média dos entrevistados apresentam sintomas graves de ansiedade, podendo sugerir que a ansiedade seja uma característica importante dessa população. As estratégias de enfrentamento mais utilizadas por esta população foram a reavaliação e o suporte social. Com relação aos resultados da percepção de suporte familiar, podemos perceber que os dados da amostra não apresentaram diferença significativa ao serem comparados com os dados normativos da escala. / Theoretical basis: Quality of life is an important studied variable in health sciences and has become an important indicator in assessing states and health outcome. Chronic diseases are characterized by a prolonged course, sometimes accompanying the carrier all his life, which can influence the perception that the individual has of himself and of his life. The neurofibromatosis type 1 (NF1) is a chronic and genetics condition that affects about 1: 3500 births. Besides being a disease that leads to a greater predisposition to develop tumors, NF1 has physical symptoms of easy identification. Objective: This project aims to study the quality of life and emotional variables of people with neurofibromatosis type 1. Method: This is an observational study. The overall quality of life variables were evaluated (WHOQOL-bref and SF-36), specific quality of life for people with skin problems (DLQI-bra), depressive symptoms (BDI), anxiety symptoms (BAI), perception of family supports (IPSF) and coping strategies (coping strategies Inventory of Folkman and Lazarus). The participants were also evaluated for the severity (Riccardi Scale) and visibility of disease symptoms (Ablon). Results: Were collected data from 71 adults patients with NF1. From all sample 60% were female. The mean age was ± 40.36 years . Of the 52 patients evaluated for Riccardi scale , 11.3 % had mild severity , 40.4 % moderate severity , 42% Severity of symptoms and 6.5 % symptoms very severe. The data of the visibility of the symptoms were measure by Ablon scale , 36.5 % have mild symptoms visibility , 30.8 % moderate and 32.7 % severe visibility of symptoms. Conclusion: The results of the quality of life of people with NF1, when compared with the normative data for sample, indicate no statistically significant difference. The analysis of depressive symptoms indicated that the majority of respondents have mild symptoms of depression and the BAI scale data related to symptoms of anxiety found that the average of respondents have severe anxiety symptoms and may suggest that anxiety can be an important feature of this population. Coping strategies most used by this population were the re-evaluation and social support. Regarding the results of the perception of family support, we can see that the sample data showed no significant difference when compared with the normative data range.

Made available in DSpace on 2014-06-11T19:22:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-09-14Bitstream added on 2014-06-13T20:09:59Z : No. of bitstreams: 1 corazza_di_me_rcla.pdf: 708834 bytes, checksum: 0576ea18544a0cbe0f01513017cda19e (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O objetivo do presente estudo foi verificar a influência de um programa de atividade física regular sobre sintomas depressivos e nível de atividade física em idosos institucionalizados. Participaram do estudo 43 idosos institucionalizados, divididos em três grupos: Grupo de Atividade Física (GAF), Grupo Controle (GCT) e Grupo de Convívio Social (GCS). Os participantes foram caracterizados quanto à idade, escolaridade e funções cognitivas, não apresentando diferenças significativas. O GAF atendeu a um programa de atividade física regular, durante 6 meses, com freqüência de 3 sessões semanais de 60 minutos. O GCS atendeu a um programa de atividades de entretenimento. Todos os participantes responderam à Escala para Depressão em Geriatria (GDS) e ao Questionário Baecke Modificado para Idosos (QBMI), antes (pré) e após (pós) as intervenções. Os resultados foram interpretados por meio da ANOVA de medidas repetidas, com nível de significância de p<0,05. Foi encontrada interação entre grupos e momentos, sendo também constatada correlação moderada e significativa entre as variáveis. Apenas o GAF e o GCS apresentaram influência positiva para sintomas depressivos, enquanto o GCT apresentou aumento dos mesmos. Para nível de atividade física somente o GAF apresentou um incremento. Com tais resultados conclui-se que, em idosos institucionalizados; a) baixos níveis de atividade física podem ser um fator de risco para sintomas depressivos; b) programas de atividade física ou de contatos sociais são aptos a reduzir sintomas depressivos; c) programas de atividade física parecem ser mais efetivos para aumentar o nível de atividade física e contrapor-se a sintomas depressivos comparado com programas de convívio social sem atividade física; d) o não envolvimento com programas de atividade física ou de contato social aumenta o risco para sintomas depressivos. / The objective of the present study was to verify the influence of a program of regular physical activity on depressive symptoms and level of physical activity in institutionalized older people. Forty-three institutionalized older people were assigned to three groups: Physical Activity Group (PAG), Control Group (CTG) and Social Contact Group (SCG). Chronological age, instruction level) and cognitive functions did not show any statistical significant difference among the groups. The PAG carried out a 6-month program of regular and generalized physical activity, three 60-minute sessions per week. The SCG carried out a program of entertainment activities. The participants answered the Geriatric Depression Scale (GDS) and the Baecke Questionnaire Modified for Elderly (BQME), both before and after the interventions. The results were analyzed by means of ANOVA of repeated measures, to the level of significance p< 0,05. The ANOVA revealed an interaction between groups and moments. The PAG and SCG presented a reduction on depressive symptoms, while the CTG increased. In physical activity level the PAG increased. These results leads to the following conclusions, regarding institutionalized older people: a) lower levels of physical activity seem to be a risk factor for depressive symptoms; b) physical activity or social contacts programs are able to reduce depressive symptoms; c) physical activity programs seem to be more effective to foster physical activity levels and to counteract depressive symptoms compared to social contact programs with no physical activity and, d) no involvement in physical activity or social contact programs increases the risk for depressive symptoms.

Base teórica: A qualidade de vida é uma variável amplamente estudada nas ciências da saúde e tem se tornado, cada vez mais, um indicativo importante na avaliação dos estados e desfechos de saúde. As doenças crônicas se caracterizam por curso prolongado, por vezes acompanhando o portador por toda sua vida, o que pode influenciar a percepção que o indivíduo tem de si mesmo e de sua vida. A Neurofibromatose tipo 1 (NF1) é uma doença crônica, genética, que atinge cerca de 1:3500 nascimentos. Além de ser uma doença que acarreta uma maior predisposição ao desenvolvimento de tumores, a NF1 possui sintomas físicos de fácil identificação. Objetivo: O presente estudo visa estudar a qualidade de vida e algumas variáveis emocionais de pessoas com neurofibromatose tipo 1. Método: Trata-se de um estudo transversal. Foram avaliadas as variáveis de qualidade de vida genérica (WHOQOL-bref e SF-36), qualidade de vida específica para pessoas com problemas de pele (DLQI-bra), sintomas depressivos (BDI), sintomas de ansiedade(BAI), percepção de suporte familiar (IPSF) e estratégias de enfrentamento (Inventário de Estratégias de Coping de Folkman e Lazarus). Os participantes deste estudo também foram avaliados quanto à gravidade (Escala de Riccardi) e visibilidade dos sintomas da doença (Ablon). Resultados: Foram coletados dados de 71 pacientes adultos com NF1. Do total 60,0% da amostra foram pessoas do sexo feminino, a média de idade foi de ± 40,36 anos. Dos 52 pacientes avaliados pela escala de Riccardi, 11,3% apresentou gravidade leve, 40,4% gravidade moderada, 42% sintomas graves de gravidade e 6,5% sintomas muito graves da doença. Com relação a visibilidade dos sintomas medidos pela escala de Ablon, 36,5% apresentam visibilidade leve de sintomas, 30,8% visibilidade moderada e 32.7% visibilidade severa dos sintomas. Conclusão: Os resultados da avaliação de qualidade de vida de pessoas com NF1, ao serem comparados com os dados normativos para amostra, não apresentou diferença estatisticamente significativa. A análise dos sintomas depressivos indicou que grande parte dos entrevistados apresentam sintomas leves de depressão e os dados da escala BAI referente aos sintomas de ansiedade constatou que a média dos entrevistados apresentam sintomas graves de ansiedade, podendo sugerir que a ansiedade seja uma característica importante dessa população. As estratégias de enfrentamento mais utilizadas por esta população foram a reavaliação e o suporte social. Com relação aos resultados da percepção de suporte familiar, podemos perceber que os dados da amostra não apresentaram diferença significativa ao serem comparados com os dados normativos da escala. / Theoretical basis: Quality of life is an important studied variable in health sciences and has become an important indicator in assessing states and health outcome. Chronic diseases are characterized by a prolonged course, sometimes accompanying the carrier all his life, which can influence the perception that the individual has of himself and of his life. The neurofibromatosis type 1 (NF1) is a chronic and genetics condition that affects about 1: 3500 births. Besides being a disease that leads to a greater predisposition to develop tumors, NF1 has physical symptoms of easy identification. Objective: This project aims to study the quality of life and emotional variables of people with neurofibromatosis type 1. Method: This is an observational study. The overall quality of life variables were evaluated (WHOQOL-bref and SF-36), specific quality of life for people with skin problems (DLQI-bra), depressive symptoms (BDI), anxiety symptoms (BAI), perception of family supports (IPSF) and coping strategies (coping strategies Inventory of Folkman and Lazarus). The participants were also evaluated for the severity (Riccardi Scale) and visibility of disease symptoms (Ablon). Results: Were collected data from 71 adults patients with NF1. From all sample 60% were female. The mean age was ± 40.36 years . Of the 52 patients evaluated for Riccardi scale , 11.3 % had mild severity , 40.4 % moderate severity , 42% Severity of symptoms and 6.5 % symptoms very severe. The data of the visibility of the symptoms were measure by Ablon scale , 36.5 % have mild symptoms visibility , 30.8 % moderate and 32.7 % severe visibility of symptoms. Conclusion: The results of the quality of life of people with NF1, when compared with the normative data for sample, indicate no statistically significant difference. The analysis of depressive symptoms indicated that the majority of respondents have mild symptoms of depression and the BAI scale data related to symptoms of anxiety found that the average of respondents have severe anxiety symptoms and may suggest that anxiety can be an important feature of this population. Coping strategies most used by this population were the re-evaluation and social support. Regarding the results of the perception of family support, we can see that the sample data showed no significant difference when compared with the normative data range.

Possibilities of prevention reflecting geriatric principles: Functional status and depressivity in old age Hana Vaňková, MD Abstract Background: Given the population ageing in Europe and in the Czech Republic, strategies aiming to prevent functional decline in older age are of great importance. Depression in old age increases functional decline and is also associated with increased morbidity, mortality and deterioration of quality of life (Anstey et al., 2007; Karakaya et al., 2009). Therefore, there is a need for a comprehensive intervention addressing both functional status and depressive symptoms. Methods: Using comprehensive geriatric assessment, the relationship between functional status and depressive symptoms was examined in 308 residents of long-term care facilities (RCFs) in the Czech Republic. Depressive symptoms were measured using the 15-item Geriatric Depression Scale. An additional randomized control trial (RCT) evaluated the effect of a dance-based therapy on depressive symptoms in 162 institutionalized older adults with average age over 80 years. Results: A multiple regression analyses adjusted for sociodemographic factors and for taking antidepressants found that cognitive function and functional limitation by pain were most strongly associated with depressive symptoms. The ability to...

Submitted by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2018-09-19T13:10:59Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) FICHA CATOLOGRAFICA MARCIA FARIAS DE AMORIM (2).pdf: 710614 bytes, checksum: 12c5d565347cd059f7347fd6e178713e (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2018-09-19T13:11:16Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) FICHA CATOLOGRAFICA MARCIA FARIAS DE AMORIM (2).pdf: 710614 bytes, checksum: 12c5d565347cd059f7347fd6e178713e (MD5) / Made available in DSpace on 2018-09-19T13:11:16Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) FICHA CATOLOGRAFICA MARCIA FARIAS DE AMORIM (2).pdf: 710614 bytes, checksum: 12c5d565347cd059f7347fd6e178713e (MD5) Previous issue date: 2018-02-26 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The symptoms of depressive disorders affect most women between four to six weeks after delivery, being frequent in the postpartum period due to the various transformations that the woman passes this stage, but it is possible to identify depressive symptoms for periods less than four weeks and this relates to the Quality of Life that involves meanings that reflect in diverse dimensions of the human being, covering their experiences, knowledge, individual and collective values. Objective: To identify the depressive symptomatology and its association with the quality of life of women in the postpartum period. Method: Application of Edinburgh Postpartum Depression Scale (EPDS), the Quality of Life Index (QLI) Ferrans & Powers, version adapted to the postpartum period, as well as a form to identify the sociodemographic and obstetric profile of mothers. This is a descriptive, cross-sectional, quantitative approach. Analyzed quantitative of 134 mothers from December / 2017 to April / 2018 who had their births attended in the maternity Ana Braga, located in the East Zone of the city of Manaus. Results: There was a prevalence of 17.2% postpartum depression signals from depressive symptoms identified by the application EPDS and association between postpartum depression symptoms and quality of life. Conclusion: The prevalence of depressive symptoms in the puerperium is high, suggesting postpartum depression. Factors such as low socioeconomic status are risk for the development of symptoms, but compared to the areas of QLI, the socio-economic domain is negligible in evaluating the quality of life. / Os sintomas de transtornos depressivos acometem a maioria das mulheres entre quatro a seis semanas após o parto, sendo frequentes no período puerperal devido às diversas transformações pelas quais a mulher passa nesta fase, porém, é possível identificar sintomatologia depressiva em períodos menores que quatro semanas e com isso relaciona-se a Qualidade de Vida que envolve significados que refletem em diversas dimensões do ser humano, abrangendo suas experiências, conhecimentos, valores individuais e coletivos. Objetivo: Identificar a sintomatologia depressiva e sua associação com qualidade de vida de mulheres no puerpério mediato. Método: aplicação da Escala de Depressão Pós-parto de Edimburgo (EDPE), o Índice de Qualidade de Vida (IQV) de Ferrans & Powers, uma versão adaptada para o puerpério, além de um formulário para identificação do perfil sociodemográfico e obstétrico das puérperas. Trata-se de uma pesquisa descritiva, transversal, de abordagem quantitativa. Analisou-se um quantitativo de 134 puérperas no período de dezembro/2017 a abril/2018 que tiveram seus partos assistidos na Maternidade Ana Braga, localizada na Zona Leste da cidade de Manaus. Resultados: Foi identificada prevalência de 17,2% de sinais de depressão pós-parto a partir de sintomas depressivos identificados pela aplicação da EDPE, e associação entre a sintomatologia depressiva no puerpério e a qualidade de vida. Conclusão: É alta a prevalência de sintomas depressivos no puerpério, que sugerem estado de depressão pós-parto. Fatores como a baixa condição socioeconômica representam risco para desenvolvimento dos sintomas, mas em comparação aos domínios do IQV, o domínio socioeconômico é pouco significativo na avaliação da qualidade de vida.