INTRODUÇÃO. Depressão é reconhecida como um grave problema de saúde pública, por ser a causa mais frequente de sofrimento emocional e redução da qualidade de vida. No entanto, são escassos os estudos que investigam depressão e fatores associados em idosos de países em desenvolvimento. OBJETIVO E MÉTODO. Estudo transversal de base populacional com 1563 indivíduos idosos (>= 60 anos) de três diferentes classes socioeconômicas (alta, média e baixa) da cidade de São Paulo. Os sujeitos foram avaliados em domicílio (fase de rastreamento ou fase I) e hospital (fase diagnóstica ou fase II). Este é um estudo de análise de dados, que descreve a prevalência observada de transtornos depressivos em idosos, investigando a associação com fatores sociodemográficos, comprometimento cognitivo e funcional (CCF), hábitos de vida e comorbidades clínicas. Os seguintes instrumentos foram aplicados: Mini Exame do Estado Mental (MMSE) e Bayer Activity of Daily Living (B-ADL); questionário da Associação Brasileira de Pesquisa de Mercado (ABIPEME); CAMDEX (Cambridge Mental Disorders of the Elderly Examination); escala para rastreio de depressão em idosos (D-10). O diagnóstico de depressão maior foi feito de acordo com o DSM -IV- TR. RESULTADOS. A amostra final consistiu em 1.563 idosos (68,7% mulheres e 31,3% homens). A idade média foi de 71,5 anos e 58,3% tinham escolaridade <=4 anos. Os \"screen-positives\" para depressão ou os idosos com SDCR (n=136) representavam 13.0% (IC 95%: 11-15) da amostra. Depressão maior foi diagnosticada em 60 idosos avaliados na segunda fase do estudo. A prevalência observada foi de 3,8% (IC 95%: 2,8% a 4,7%). Em modelos de regressão logística \"stepwise\", maior Razão de Chances do diagnóstico de depressão estava associada com gênero feminino, ser viúvo, episódio depressivo prévio, HAS, uso de psicotrópicos, comprometimento cognitivo e funcional, e uso de álcool (fatores de risco potenciais). Por outro lado, menor Razão de Chances do diagnóstico de depressão estava associada com atividade física e ir ao cinema (fatores protetores potenciais). CONCLUSÃO. A prevalência de depressão 14 maior é consistente com valores anteriormente encontrados em estudos nacionais e internacionais. Como mencionado na literatura atual, nosso estudo confirma a associação entre depressão e fatores potencialmente modificáveis, reforçando o possível benefício de medidas preventivas, que promovam estilos de vida saudáveis, atividades de lazer e prática de exercício físico, bem como o diagnóstico e tratamento de doenças clínicas, especialmente na atenção primária. Além disso, a associação significativa entre depressão e déficit cognitivo e funcional incentiva a realização de estudos longitudinais para melhor investigar esta relação e permitir intervenções precoces em populações de risco para o desenvolvimento de doenças psiquiátricas e demência, incluindo a doença de Alzheimer / INTRODUCTION. Depression is recognized as a serious public health problem because it is the most frequent cause of emotional distress and reduced quality of life. However, studies investigating major depression and associated factors in older people from developing countries are scarce. OBJECTIVE AND METHODS. Cross-sectional study of population-based 1563 older subjects (>= 60 years) from three different socioeconomic classes (high, medium and low) of the city of São Paulo. The subjects were assessed at home (phase I or screening phase) and hospital (diagnostic phase or phase II). This is a study of data analysis, which describes the observed prevalence of depressive disorders in the elderly, identifying their relationship with sociodemographic factors, cognitive and functional impairment (CFI), lifestyle and clinical diseases. The following instruments were applied: Mini Mental State Examination (MMSE) and Bayer Activity of Daily Living (B- ADL) questionnaire of the Brazilian Association of Market Research (ABIPEME); Cambridge Mental Disorders of the Elderly Examination (CAMDEX); screening scale for depression in the elderly (D -10). The diagnosis of major depression was made according to DSM- IV -TR. RESULTS. The final sample consisted of 1563 elderly (68.7 % women and 31.3 % men). The mean age was 71.5 years and 58.3% had 4 or fewer years of schooling. The \"screen-positives\" for depression or the elderly with CSDS (n = 136) accounted for 13.0 % (95% CI: 11%-15%) of the sample. Major depression was diagnosed in 60 patients included in the second phase of the study. The prevalence was 3.8 % (95% CI: 2.8% to 4.7 %). In logistic regression stepwise models, a higher odds ratio of depression diagnosis was associated with female gender, being widowed, previous depressive episode, hypertension, use of psychotropic medication, cognitive and functional impairment, and alcohol use (potential risk factors). On the other hand, a lower odds ratio of depression diagnosis was associated with physical activity and going to cinema (potential protective factors). CONCLUSION. The prevalence of major depression is consistent with figures previously found in Brazilian and international studies. As 16 mentioned in the literature at the moment, our study confirms the association between depression and potentially modifiable factors, reinforcing the benefit of probable preventive measures, to incentive healthy lifestyles, leisure activities and the practice of physical exercise, as well as the diagnosis and treatment of clinical diseases, especially in primary care. In addition, significant association between major depression and cognitive and functional impairment encourages further longitudinal studies to better investigate this relationship and enable earlier interventions in populations at risk for developing psychiatric disorders and dementia, including Alzheimer\'s disease. Descriptors: depressive disorder, depressive symptoms, elderly, cross-sectional studies, epidemiology, prevalence

O Brasil é um país em que o número de idosos tem crescido vertiginosamente e com isso ocorrem mudanças no perfil demográfico, socioeconômico e epidemiológico. As doenças crônicas assumem posição de destaque, dentre elas o Acidente Vascular Cerebral - AVC. O objetivo foi determinar a incidência de sintomas depressivos em idosos que foram hospitalizados por AVC, após a alta hospitalar. Trata-se de um estudo observacional e prospectivo com abordagem quantitativa. Foram entrevistados 48 idosos (60 anos ou mais) residentes na comunidade de cidades do interior paulista, que sofreram AVC e foram internados em um hospital terciário. A coleta dos dados foi realizada através de visitas domiciliares em duas etapas (após três e seis meses do AVC), no período de maio de 2010 a março de 2011. O instrumento de coleta de dados foi composto por dados demográficos e socioeconômicos, Mini-Exame do Estado Mental (MEEM), Atividades Instrumentais da Vida Diária (AIVD), Medida de Independência Funcional (MIF), presença de comorbidades e Escala de Depressão Geriátrica (GDS). A média de idade foi de 72,4 (±7,5) anos, com predominância do sexo masculino (56,2%). A maioria era composta por idosos casados, com média de 3,4 anos de estudo, 75% tinham renda familiar maior que um salário mínimo, 89,6% moravam acompanhados e 56,3% possuíam cinco ou mais morbidades. O tipo de AVC mais prevalente foi o isquêmico (81,2%), com maior comprometimento do lado esquerdo do cérebro. Com relação à Capacidade Funcional (CF), houve um aumento da média da MIF do terceiro para o sexto mês, ou seja, os idosos se tornaram mais independentes nesse quesito. Com as AIVD ocorre o contrário, os idosos se tornam mais dependentes na segunda avaliação. Os idosos do sexo masculino se tornaram menos depressivos, enquanto as idosas sofreram mais desses sintomas após seis meses do AVC. Embora o AVC seja a primeira causa de morte no país e também o grande responsável pelas incapacidades (físicas e emocionais) e internações hospitalares, estudos sobre a morbidade ainda é escasso. O intuito desse trabalho é o de apresentar essas consequências e os sintomas depressivos, os quais podem ser prevenidos com avaliação e intervenção de equipe interdisciplinar. / Brazil is a country in which the number of elderly people has displayed a steep growth, entailing changes in the demographic, socioeconomic and epidemiological profile. Chronic conditions stand out, including Cerebrovascular Accident - CVA. The aim was to determine the incidence of depressive symptoms in elderly people hospitalized due to CVA, after discharge from hospital. An observational and prospective study with a quantitative approach was carried out. Forty-eight elderly people (aged 60 years or older) were interviewed who lived in the community in interior cities in São Paulo State, had been victims of a CVA and were hospitalized at a tertiary-care hospital. Data were collected through home visits in two phases (three and six months after the CVA), between May 2010 and March 2011. The data collection instrument comprises demographic and socioeconomic data, the Mini-Mental State Examination (MMSE), Instrumental Activities of Daily Living (IADL), Functional Independent Measure (FIM), presence of co-morbidities and the Geriatric Depression Scale (GDS). The mean age was 72.4 (±7.5) years and the male gender predominated (56.2%). Most elderly were married, the mean education time was 3.4 years, 75% gained a family income of more than one minimum wage, 89.6% lived with another person and 56.3% suffered from five or more co-morbidities. The most prevalent type of CVA was ischemic (81,2%), which more strongly affects the left side of the brain. Regarding Functional Capacity (FC), the mean FIM score increased between the third and sixth month, that is, the elderly became more independent in this regard. The opposite occurred with the IADL, as the elderly become increasingly dependent on the second assessment. Male elderly became less depressed, while these symptoms were more present among female elderly six months after the CVA. Although CVA is the first cause of death in the country and also the main responsible for (physical and emotional) disabilities and hospitalizations, studies on this morbidity remain scarce. This research aims to present these consequences and depressive symptoms, which can be prevented through multidisciplinary team assessment and intervention.

Forskning visar att män är mindre benägna att söka hjälp för sin psykiska ohälsa och att normer för hur en man ska vara ligger bakom deras ovilja att söka professionell hjälp. Syftet med denna kvalitativa studie var att undersöka om och på vilket sätt maskulinitetsnormer påverkar unga mäns föreställningar kring depression och depressiva symtom bland män. Detta studeras utifrån Connells (1999) teori om hegemonisk maskulinitet och Link och Phelans (2001) konceptualisering av stigma. För att uppfylla syftet genomfördes tre stycken fokusgruppsintervjuer med unga män mellan 20 och 35 år. Studiens huvudsakliga resultat visade att männen som intervjuades framhöll egenskaper som händig, hård, disciplinerad och stark som typiskt manliga och önskvärda hos en man. Männen beskrev att män inte söker hjälp på grund av en rädsla för att uppfattas som svaga och att det finns en bild av deprimerade män som ensamma och onormala. Studiens slutsats var att maskulinitetsnormer, att betraktas som icke-maskulin samt rädslan för att stigmatiseras låg till grund för hur de intervjuade männen resonerade kring och talade om män med depression och hur det hanteras. / Research shows that men are less likely to seek help for their mental health issues and that masculine norms that dictate how a man should be lie behind this unwillingness to seek help. The objective of this qualitative study was to research how masculinity norms impact young mens perceptions about men with depression or depressive symptoms. This was accomplished through Connells (1999) theory about hegemonic masculinity and Link and Phelans (2001) conceptualization of stigma. In order to fulfill the purpose of this study three focus group interviews were conducted with young men between the ages of 20 and 35 years. The main results show that the interviewed men described traits such as being handy, strong, disciplined and tough as typically manly and desirable in a man. According to the men the fear of seeking help that exists among men stems in the fear of being perceived as weak and there is an idea of depressed men being lonely and abnormal. The conclusion of this study is that masculine norms, being perceived as non-masculine and the fear of stigmatization are important factors behind how the interviewed men reasoned and talked about men with depression and how they handle it.

Suicide is a significant public health concern and the second leading cause of death for college students. Perceived stress, depression, and mental health stigma are established risk factors for suicidal behavior; however, their interrelationships are unknown. Data were collected from 913 collegiate housing residents (70.8% female; N = 646). Using data from self-report measures, depressive symptoms were examined as a mediator of the relation between stress and suicidal behavior, along with the moderating effect of mental health stigma. Depressive symptoms partially mediated the stress–suicide linkage, and mental health stigma was a significant moderator of the associations between stress and depression, depression and suicidal behavior, and stress and suicidal behavior. Stigmatized attitudes toward mental health treatment, including fear of social repercussion, may exacerbate the deleterious impact of stress on psychopathology and suicide risk. Individual-level therapeutic strategies targeting stress and psychopathology, as well as public health approaches that directly address and attempt to reduce mental health stigma, may reduce suicide risk in college students.

Bakgrund: Depressiva symtom (DS) är vanligt förekommande under graviditeten samtidigt som den fysiska aktivitetsnivån tenderar att minska under graviditeten. Få studier har undersökt sambandet mellan fysisk aktivitet (FA) och DS hos gravida kvinnor i Sverige. Syfte: Att kartlägga fysiska aktivitetsnivå och förekomst av DS hos gravida kvinnor i Sverige. Undersöka om det finns samband mellan dessa variabler och om det finns skillnad i DS mellan de som uppnår rekommendationerna för FA och de som inte gör det. Metod: En kvantitativ tvärsnittsstudie som undersökte FA med The International Physical Activity Short Form och DS med Edinburgh Postnatal Depression Scale (EPDS). 86 gravida kvinnor inkluderades i studien. Resultat: Totalt 72% av deltagarna uppnådde rekommendationerna för FA. 29% av deltagarna var fysiskt aktiva på en låg nivå, 47% på en måttlig nivå och 24% på en hög nivå. 21% av deltagarna hade DS enligt EPDS. Det fanns inget signifikant samband mellan FA och poäng på EPDS. Det förekom ingen signifikant skillnad i poäng på EPDS mellan de som uppnådde rekommendationerna för FA och de som inte gjorde det. Konklusion: Majoriteten av deltagarna uppnådde rekommendationerna för FA. Ungefär en femtedel av deltagarna fick över 12 poäng på EPDS vilket indikerar ett behov för utredning av eventuell depression. Det fanns inget samband mellan FA och poäng på EPDS. Ingen signifikant skillnad mellan grupperna kunde påvisas. Vidare forskning behövs för att studera FA som behandling vid DS under graviditet. / Background:Depressive symptoms (DS) are common during pregnancy and physical activity (PA) tend to decrease during pregnancy. Few studies have examined the relationship between PA and DS in pregnant women in Sweden. Purpose:Examine the physical activity level and presence of DS in pregnant women in Sweden. Examine the relationship between these variables and the difference in DS between those who fulfilled the recommendations for PA and those who did not. Methods:A quantitative cross-sectional study investigating PA with The International Physical Activity Short Form and DS with the Edinburgh Postnatal Depression Scale (EPDS). 86 pregnant women were included in the study. Results:A total of 72% of the participants achieved the recommendations for PA. 29% were physically active at a low level, 47% at a moderate level and 24% at a high level. 21% of the participants had DS according to EPDS. There was no significant association between PA and points on EPDS. There was no significant difference in points on EPDS between those who achieved the recommendations for PA and those who did not. Conclusion:The majority of the participants achieved the recommendations for PA. About one-fifth of the participants received more than 12 points on EPDS, indicating a need for an investigation of possible depression. There was no association between FA and points on EPDS. No significant difference between the groups was detected. Further research is needed to study PA as a treatment for DS during pregnancy.

Psykisk ohälsa är ett växande samhällsproblem, både globalt och i Sverige och risken att drabbas ökar med stigande ålder. Depression hos en äldre person kan vara svårt att uppmärksamma. Äldre som utsätts för en ökad psykisk belastning, som till exempel i samband med sjukdom, förluster av närstående och ensamhetskänslor, riskerar att utveckla depressiva symtom. Dessa symtom utsätter den äldre för ett stort lidande, ökar risken att dö i förtid samt utgör en stor samhällskostnad. Syftet var att studera distriktssköterskans erfarenheter när det gäller att uppmärksamma och förbättra depressiva symtom hos äldre inom kommunal hemsjukvård. Metoden var kvalitativ och hade en induktiv ansats. Åtta distriktssköterskor i fem olika kommuner i södra Sverige intervjuades i 30-60 minuter. Med hjälp av en intervjuguide delgav distriktssköterskorna fritt sina erfarenheter. Innehållsanalysen var kvalitativ och innebar att meningsbärande enheter identifierades och processades till underkategorier samt abstraherades till kategorier. I resultatet framkom att distriktssköterskan använde sin intuitiva förmåga samt förlitade sig på sin erfarenhet, då han/hon i mötet och samtalet med den äldre uppmärksammat depressiva symtom. Mötet och samtalet med den äldre visade sig även vara viktiga redskap för att förbättra dessa symtom. Skattningsinstrument nyttjades inte i någon av kommunerna. Distriktssköterskan i hemsjukvården har en unik möjlighet att på ett tidigt stadium uppmärksamma depressiva symtom samt genom olika omvårdnadshandlingar förbättra dessa symtom. Genom att stå upp för den äldres rättighet till den vård och behandling han/hon är i behov av, får distriktssköterskan en nyckelfunktion i rollen som den äldres företrädare. / Mental illness is a growing problem in society, both global and in Sweden and the risk of suffering from depressive symptoms (DS) increases with ageing. It can be difficult to identify DS in an older person. Elderly people are sometimes at a higher risk of mental pressure, when at the same time dealing with sickness, loss of close relationships and loneliness, which often lead to DS. These symptoms cause the elderly person a great suffering, increases the risk of dying prematurely and is a big cost for the society. The aim was to study district nurses experiences when it comes to identify and improve DS by elderly people in municipal home nursing. The method was qualitative and had an inductive approach. Eight district nurses from five different municipalities in southern Sweden were interviewed for 30-60 minutes. The analysis was qualitative which means that parts with meaning contents were identified and processed into categories and subcategories. The result showed that district nurses used their intuitive ability and leaned on their experience, when in an encounter and in a conversation with an elderly person identified DS. The encounter and the conversation with an elderly person turned out to be an important instrument even when it came to improve these symptoms. A valuation scale was not used in any of the municipalities. The district nurse in home nursing has and unique possibility to, in an early stage, identify DS and by different caring actions improve these symptoms. By standing up for the elderly person's right to get the care and treatment he/she is in need of, the district nurse has a key function in the role as the elderly person’s representative.

Background: The Patient Health Questionnaire PHQ-9 is a widely used instrument to screen for depression in clinical research. The first aim of this study was to psychometrically test the PHQ-9 in a large sample of cancer patients. The second aim was to calculate unbiased estimates of the depression burden for several cancer groups taking into account age and gender distributions. Methods: A sample of 2,059 cancer patients with varying diagnoses were examined in this study six months after discharge from a rehabilitation clinic. A representative sample of 2,693 people from the general population served as controls. Expected PHQ-9 mean scores of the general population sample, regressed on age and gender, were calculated to enable a fair comparison of different groups of cancer patients. Results: While the reliability (Cronbach’s alpha) for the PHQ-9 scale was good (alpha ≥ 0.84), the CFA fit indices of the one-dimensional solution were unsatisfactory in the patients’ sample. The factorial analysis confirmed two factors. PHQ-9 mean scores for 15 types of cancer are given, ranging from 4.0 (prostate) to 8.2 (thyroid gland). Differences between expected mean scores (derived from the general population) and raw mean scores of the cancer subsamples are reported that provide a better estimate of the depression burden. Conclusions: The results confirmed that the PHQ-9 performs well in testing depression in cancer patients. Regression coefficients can be used for performing unbiased comparisons among cancer groups, not only for this study. The burden of patients with testis cancer and Hodgkin lymphoma is underestimated when age and gender are not taken into account.

Sibling contact (synchronous or asynchronous) in young adulthood may have implications for individual well-being (health, life satisfaction & depressive symptoms). This link may be moderated by each individuals' traits, specifically autistic characteristics. Current literature has examined sibling contact, mediums of contact, autism relationships, but has yet to consider sibling contact moderated by autistic traits. This study analyzed data from 390 young adults 61% female, mean age = 25.65) who gave self-reports over two collection waves. Structural Equation Models found that regardless of autistic traits, synchronous contact was linked with increased life satisfaction as well as lower depressive symptoms, and asynchronous contact was linked with increased life satisfaction. Interactions between each type of contact and autistic traits found that for those lower in autistic traits, increases in each type of contact was linked with greater life satisfaction, and higher levels of asynchronous contact was linked with lower depressive symptoms, for those with lower levels of autistic traits. Autistic traits do moderate the process of siblings communicating and create a neutral space for those who are higher in traits. Young adults should prioritize sibling contact to improve their life satisfaction and depressive symptoms, and clinicians should encourage sibling contact in young adulthood.

Bakgrund: Psykisk ohälsa och depression ökar bland den äldre befolkningen. Detta ökar risken för försämrad fysisk hälsa samt förtida död. Sjuksköterskans bemötande och omvårdnad är ofta avgörande för välbefinnandet hos äldre med depressiva symtom eller depression. Syfte: Att beskriva sjuksköterskors erfarenheter av omvårdnadsåtgärder till äldre med depressiva symtom eller depression. Metod: En allmän litteraturstudie gjordes där tio vetenskapliga artiklar analyserades och sammanställdes i en innehållsanalys. Resultat: Presenteras under tre huvudkategorier; Sjuksköterskors kunskapsnivå: Sjuksköterskor anser att äldre patienter som lider av depressiva symtom eller depression utsätts för stort lidande på grund av sjuksköterskornas bristande utbildning; Omvårdnadsåtgärder: Sjuksköterkor anser att omvårdnadsåtgärder bör prioriteras högre än farmakologiska åtgärder, främst i de fall där patientens vardagliga behov inte uppfylls; Brister i omvårdnaden: Sjuksköterskor upplever brist på resurser såsom tid och personal. Konklusion/Implikation: Utbildning för sjuksköterskor, inom depression hos äldre bör utvecklas och erbjudas, både i grundutbildningen och inom praktisk vårdverksamhet där även tydligare riktlinjer behövs. / Background: Mental illness and depression are increasing among the elderly population. This increases the risk of deteriorating physical health and premature death. The nurse's treatment and care are often crucial for the well-being of the elderly with depressive symptoms or depression. Aim: To describe nurses' experiences of nursing care for the elderly with depressive symptoms or depression. Method: A general literature study was done where ten scientific articles were analyzed and compiled in a content analysis. Result: Presented under three main categories; Nurses 'level of knowledge: Nurses believe that elderly patients suffering from depressive symptoms or depression are exposed to great suffering due to the nurses' lack of education; Nursing interventions: Nurses believes that nursing interventions should be given higher priority than pharmacological interventions, especially in cases where the patient's everyday needs are not fulfilled; Deficiencies in nursing: Nurses experience a lack of resources such as time and personnel. Conclusion/Implication: Education for nurses, in depression among elderly should be developed and offered, both in basic education and in practical care activities where even clearer guidelines are needed.

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