The overall goal of the current study was to determine whether experiences of relational and physical victimization were related to anxiety and depressive symptoms in a sample of emerging adults. This study also investigated whether these associations were moderated by gender, as well as by sympathetic nervous system (SNS) and parasympathetic nervous system (PNS) reactivity to peer stress. Although work in this area has focused on children (e.g., Cullerton-Sen & Crick, 2005; Rudolph et al., 2009), it appears the presence and function of victimization changes with age, and the negative effects of victimization can last through early adulthood (e.g., Gros et al., 2010; Kumpulainen et al., 1999; Roth et al., 2002). Despite the potential for victimization to influence outcomes in emerging adults, research on these associations is lacking in this age group (Heilbron & Prinstein, 2008). A goal of the current study was to examine these processes in an older sample. Additionally, as individuals may react to peer victimization differently, factors that may help explain these differences were investigated. Specifically, evidence suggests that the interaction of the SNS and the PNS may serve as a moderator in the relationship between stressors and adjustment outcomes (Cummings et al., 2007; El-Sheikh et al., 2009; ObradoviÄ? et al., 2010). Further, research suggests that different patterns of interaction of the SNS and the PNS provide important information in the prediction of adjustment outcomes (El-Sheikh et al., 2009) and that both systems must be examined in order to more fully understand the relationship between physiological reactivity and adjustment outcomes (Beauchaine, 2001). Thus, in the current study, the interaction between two physiological measures, SNS reactivity to stress (as measured by skin conductance reactivity [SCL-R]) and PNS reactivity to stress (as measured by respiratory sinus arrhythmia [RSA-R]), was examined as a moderator of the association between peer victimization and adjustment outcomes. The moderating role of gender was also examined. Two hundred and forty-six emerging adults participated in the current study (74% female; Mage = 18.77) and were recruited from introductory psychology courses at a northeastern public university. Participants' SCL-R and RSA-R were assessed using a stress protocol during which they discussed an experience of relational victimization (e.g., being left out). Levels of relational and physical victimization, anxiety and depressive symptoms, and gender were gathered using self-report. Findings suggested that both physical and relational victimization were related to both anxiety and depressive symptoms. Additionally, females were more likely to experience relational victimization than males, while males were more likely to experience physical victimization than females. Relational victimization was related to depressive symptoms only in individuals demonstrating coactivation (i.e., blunted RSA withdrawal and increased SCL-R) and coinhibition (i.e., RSA withdrawal and blunted SCL-R) patterns of stress reactivity, although the interaction for this effect only approached conventional levels of statistical significance. These patterns may have emerged as a result of the breakdown of regulation in the physiological response to stress, with either the SNS or the PNS failing to perform adequately (El- Sheikh & Erath, 2011; El-Sheikh et al., 2009). These findings suggest that experiences of victimization are related to negative adjustment outcomes in emerging adults, as well as highlight potential areas that may serve as mechanisms for future interventions.

Coping with a cancer diagnosis is known to be a stressful experience that can be related to declines in personal well-being and increases in distress. Dispositional mindfulness is known to be related to depressive symptoms and well-being. The primary purpose of this study was to examine the relationship between mindfulness and experiences of depressive symptoms and well-being in people recently diagnosed with cancer. Seventy-four participants who were diagnosed with cancer in the last 12 months completed an initial self-report survey, and 43 of those completed another survey 3 months later. Cross-sectional regression analysis showed that higher levels of mindfulness were related to fewer depressive symptoms, less use of avoidant coping, and more experiences of positive affect at baseline, but not related to positive reappraisal coping at baseline. Longitudinal regression analyses showed no significant relationship between mindfulness at baseline and depressive symptoms, experiences of positive affect, positive reappraisal coping, or avoidant coping 3 months later, after controlling for the dependent variable at baseline. Additionally, cross-lagged analysis indicated no evidence of a causal relationship between mindfulness at baseline and the dependent variables 3 months later.

SYMPTOM CLUSTERS IN LUNG CANCER PATIENTS By Debra Rattican, PhD, RN A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2012 Major Director: Debra E. Lyon, PhD. Professor and Chair Family and Community Health Nursing The purpose of the study was to examine selected relationships among symptoms common to individuals with lung cancer. The specific aims were: 1) To examine the relationship between the symptoms of dyspnea and anxiety in patients with lung cancer. 2) To examine the relationships among the symptoms of dyspnea, anxiety, and symptom cluster components (depressive symptoms, fatigue, pain) in patients with lung cancer. 3) To examine the correlation between functional ability and quality of life in patients with lung cancer. 4) To explore the relationships among the symptoms of dyspnea, anxiety, and symptom cluster components (depressive symptoms, fatigue, pain) in patients with lung cancer and patients’ functional ability. 5) To explore the relationships among the symptoms of dyspnea, anxiety, and symptom cluster components (depressive symptoms, fatigue, pain) in patients with lung cancer and patients’ quality of life. Data were gathered through online survey and analyzed using descriptive, correlation, principal component analysis, exploratory factor analysis, and forward stepwise regression techniques. A strong positive correlation was found between dyspnea and anxiety (both anxiety in general and anxiety at the time the survey was completed. While results of this study cannot provide conclusive evidence of the existence of a symptom cluster composed of depressive symptoms, fatigue, and pain, the results are consistent with other studies in this area. Significant positive correlations among these three symptoms indicate that this is a possible symptom cluster experienced by lung cancer patients in general. This study provides preliminary data on how these symptoms are related and how they affect functional ability, or the ability to perform routine activities of daily living (ADLS) and instrumental activities of daily living (IADLS), and quality of life in patients with lung cancer. Further study is needed on to better understand the symptom experience of these individuals in order to develop robust interventions targeting effective symptom management.

L’objectif de ce travail était d’étudier l’évolution des symptômes dépressifs (SD) chez 2590 sujets âgés français, issus de la population générale et suivis pendant 20 ans entre 1988 et 2008. Une méthode d’analyse du changement fondée sur l’identification de trajectoires individuelles de développement a été utilisée afin de tenir compte de l’hétérogénéité pressentie dans cette population. Les facteurs et évènements évolutifs associés aux trajectoires de SD ont été étudiés. Nous avons identifié cinq trajectoires d’évolution de SD entre 1988 et 2008 et trois trajectoires entre 65 et 104 ans. La majorité des individus ne présentait pas ou peu de SD au cours des 20 ans de suivi. Cependant, environ une personne sur dix suivait une trajectoire compatible avec un diagnostic de dépression chronique. Les antécédents psychiatriques, la polymédication, les comorbidités somatiques et la perte d’autonomie étaient des facteurs fortement prédictifs de dépression « émergente » ou « persistante ». Le veuvage apparaissait être un facteur protecteur d’appartenance à la trajectoire de dépression « persistante » pour les femmes uniquement. L’entrée en institution et le décès étaient plus fréquents dans les trajectoires les plus défavorables. Les trajectoires de SD étaient significativement associées aux trajectoires de consommation d’antidépresseur. Notre travail confirme l’hétérogénéité de l’évolution des symptômes dépressifs en population âgée. Il alerte sur la prévalence préoccupante de la chronicité et aide à déterminer des sujets à plus haut risque d’évolution défavorable qui pourraient faire l’objet d’actions de prévention. / The aim of this study was to investigate patterns of the course of depressive symptoms (DS) in 2590 community-dwelling older adults followed over a period of 20 years, between 1988 and 2008. Using a group-based trajectory method, we modelled the course of DS and examined associations between trajectory patterns and baseline socio-demographic and health variables, as well as outcomes. We identified five time-related trajectories between 1988 and 2008, and three age-related trajectories between 65 and 104 years old. A majority of participants experienced no or only mild DS. However, about one to ten belonged to high-level trajectories consistent with clinically relevant chronic depression. Psychiatric history, polypharmacy, somatic comorbidities and functional limitation were strongly associated with membership to increasing and persistently high trajectories. Being widowed seemed to be a protective factor for membership of this persistently high trajectory group only in women. Institutionalization and death were more prevalent in worse trajectories. Trajectories of DS and trajectories of antidepressant use were significantly associated. Our study confirmed heterogeneity of the evolution of DS in late-life and highlighted the problematic risk of chronicity. We identified several high-risk groups for later-life depression that can be easily detected and that are amenable to preventive intervention.

Attention deficit/hyperactivity disorder (ADHD) is a childhood disorder that often persists into adulthood. Among adults, ADHD is highly comorbid with addictive behaviors (e.g., substance abuse and dependence), and depressive disorders. Recently, an association between ADHD and obesity has been reported in the literature; emotional and binge eating may be “addictive behaviors” that contribute to weight gain in this population. The purpose of this study was to test competing models of the hypothesized link between ADHD symptomology and overweight. Specifically, in Model 1, symptoms of depression are expected to mediate the relationship between symptoms of impulsivity and inattention and emotional and binge eating which, in turn, leads to weight gain (i.e., increased BMI). In Model 2, however, the impulsive symptoms have direct relationships with emotional and binge eating in addition to being mediated by depressive symptoms. Structural equation modeling (SEM) was employed to test how the models fit the data of 790 college men. Both models fit the data well, with Model 2 being preferred because of its greater connection to theory. All paths were significant indicating that increased impulsive and inattentive symptoms predicted increased symptoms of depression that, in turn, predicted increased emotional/binge eating, which has a direct and positive relationship with increased BMI. Moreover, impulsive symptoms were also directly related to emotional/binge eating, suggesting different paths to overweight across ADHD subtypes. The findings of the current study elucidate the links between ADHD symptoms and overweight (i.e., increased BMI).

Objetivos: O presente trabalho é secundário a um estudo clínico randomizado, que teve por objetivos investigar os efeitos de uma substância simbiótica sobre a permeabilidade intestinal, a inflamação sistêmica, a cognição e sintomas depressivos em idosos. Métodos: quarenta e nove participantes, 65-90 anos de idade, ambos os gêneros, foram randomizados em dois grupos: grupo S (uso de simbióticos); e grupo P (uso de placebo). As seguintes avaliações foram realizadas no início e no final do experimento: Escala de Depressão Geriátrica (GDS-15); Mini Exame do Estado Mental (MEEM); % de gordura corporal (%gordura); citocinas pró-inflamatórias e regulatórias no soro (IL-6, TNF-α e IL-10); e marcadores de permeabilidade intestinal no soro (DAO, IFABP e LPS). Resultados: A interação entre tempo e grupo mostrou maior redução do LPS no grupo P e maior aumento do IL-10 no grupo S. Considerando somente o fator tempo, ambos os grupos reduziram a %gordura, TNF-α e DAO. O IL-6, o GDS-15 e MEEM aumentaram em ambos os grupos. O valor final de GDS-15 foi explicado negativamente por DAO, IL-10, TNF-α, %gordura, ser mulher e estar alocado no grupo P. As variáveis que explicaram positivamente o valor final do GDS-15 foram IL-6, IFABP, e LPS. As variáveis positivamente associadas aos valores finais do MEEM foram IL-10, DAO, ser mulher e estar alocado no grupo P; foram encontradas associações negativas entre o MEEM e IL-6, TNF-α, %gordura, IFABP e LPS. Foi discutida a possibilidade de alguma interferência dos medicamentos utilizados pelos idosos, nas variáveis de interesse do estudo. Conclusões: de acordo com nossas condições experimentais, foram encontrados efeitos sutis da suplementação de simbióticos sobre sintomas depressivos e cognição em idosos da comunidade, aparentemente saudáveis; entretanto, os efeitos sobre a cognição parecem ter sido mais otimistas. Estudos futuros, com indivíduos com diagnóstico de depressão ou de comprometimento cognitivo, poderão clarear questões levantadas no presente estudo. / Objectives: This secondary study from a randomized clinical trial aimed to investigate the effect of a synbiotic substance on intestinal permeability, systemic inflammation, cognition and depressive symptoms in elderly. Methods: Forty-nine participants, 65-90 years old, both genders, were randomly assigned into two groups: S-group (synbiotic); and P-group (placebo). Evaluations performed at the beginning and at the end of the experiment were: Geriatric Depressive Symptoms scale (GDS-15); Mini-Mental Status Examination (MMSE); % of body fat (%fat); pro-inflammatory and regulatory cytokines (serum IL-6, TNF-α and IL-10); gut permeability (serum DAO, IFABP and LPS). Results: The interaction between time and group showed higher reduction of LPS in P-group and higher increase of IL-10 in S-group. Considering only time, both groups had reduced their %Fat, TNF-α and DAO. The IL-6, GDS-15 and MMSE were increased in both groups. The GDS-15 final was negatively explained by DAO, IL-10, TNF-α, %Fat, being woman and being allocated in P-group. The variables that positively explained the GDS-15final were the IL-6, the IFABP, and the LPS. The variables that were positively associated to MMSE final were the IL-10, DAO, being woman, and being allocated in P-group; The negative associations were IL-6, TNF-α, %Fat, IFABP and LPS. We discussed the possibility of some interference of the medicines used by the elderly on our outcomes of interest. Conclusions: our experimental conditions demonstrated weak effects of synbiotic supplementation in the management of depressive symptoms or cognitive decline in apparently healthy elderly living in the community, although the effect on cognition seems to be more optimist. Other comparative studies, with individuals diagnosed as depressive morbidity or cognitive decline, may clarify our hypothesis.

Sintomas depressivos, sedentarismo e obesidade são problemas de saúde pública prevalentes em idosos e, quando presentes, podem diminuir a qualidade de vida e aumentar a incapacidade no envelhecimento. O presente estudo teve como objetivo geral estudar a associação entre sintomas depressivos, atividade física e obesidade de idosos residentes no município de São Paulo Estudo SABE: Saúde, Bem-estar e Envelhecimento. Realizou-se estudo longitudinal, com amostra de 826 idosos. Os sintomas depressivos (SD) foram avaliados pela Escala de Depressão Geriátrica (GDS), forma abreviada de 15 itens. Foram excluídos idosos com comprometimento cognitivo e que haviam tido ajuda de informante para responder à GDS. O nível de atividade física foi avaliado pelo IPAQ (International Physical Activity Questionnaire, questionário internacional, validado e adaptado para idosos) e a obesidade pelo cálculo do Índice de Massa Corporal (IMC). Para a classificação do estado nutricional, utilizou-se a classificação da OPAS(2002). Informações sociodemográficas e econômicas (sexo, idade, escolaridade, arranjo familiar, situação conjugal, percepção de renda, situação ocupacional e arranjo familiar), informações sobre condições de saúde e importância da religião também foram avaliadas. As associações foram estudadas por meio do teste de Rao-Scott. Foi realizada a análise múltipla por meio da regressão logística (RL) tipo stepwise/forward. Foram incluídas no modelo da RL todas as variáveis que apresentaram p<0,20 na análise univariada e outras variáveis de relevância teórica. O programa estatístico utilizado para análise de dados foi o programa estatístico Stata (versão 12.0), sendo para todas as análises utilizado o nível de significância de 5 por cento . Obteve-se prevalência de 12,92 por cento de sintomas depressivos. Associaram-se significativamente a SD: sexo (OR: 3,44;IC95 por cento : 1,93-6,16), percepção de saúde classificada como regular (OR: 3,60;IC95 por cento : 1,80-7,17) e ruim (OR: 9,23;IC95 por cento : 3,32-25,66), dificuldades em realizar de uma a duas atividades básicas da vida diária (OR:1,80;IC95 por cento : 1,03-3,16) ou três ou mais atividades básicas da vida diária (OR:4,15;IC95 por cento : 1,72-10,0), ter sido classificado como insuficientemente ativo quanto às práticas de caminhadas (OR:2,38;IC95 por cento : 1,17-3,32) e não ter relatado a religião como importante em sua vida (OR:9,75;IC95 por cento : 2,10-45,14. A incidência de sintomas depressivos foi de 28,6 casos por 1.000 pessoas ano (IC: 22,7-36,7), associando-se significativamente à: tomar entre um a quatro medicamentos (OR: 3,43; IC95 por cento :1,67 7,07) e cinco ou mais medicamentos (OR:81,39; IC95 por cento :8,42-786,70), ter dificuldades para realizar de uma a duas atividades básicas da vida diária (OR:2,0; IC95 por cento : 1,04-3,85), perceber a saúde como ruim (OR: 3,85; IC95 por cento : 1,21-12,26). Praticar de forma irregular atividades físicas como a caminhada também foi um fator de risco associado aos sintomas depressivos, apesar da associação ter sido limítrofe (OR: 1,78; IC95 por cento : 0,98 3,22). Portanto, não se obteve associação significativa entre sintomas depressivos e obesidade, mas constatou-se associação de sintomas depressivos com a prática de caminhada e outros fatores que corroboram com a literatura nacional e internacional / Depressive symptoms, sedentary lifestyle and obesity are prevalent public health problems in the elderly and, when present, may decrease quality of life and increase disability in aging. The present study aimed to study the association between depressive symptoms, physical activity and obesity among elderly people living in the city of São Paulo - SABE Study: Health, Welfare and Aging. A longitudinal study was carried out, with a sample of 826 elderly. Depressive symptoms (SD) were evaluated by the Geriatric Depression Scale (GDS), abbreviated form of 15 items. Elderly individuals with cognitive impairment and who had the help of informant to respond to GDS were excluded. The level of physical activity was assessed by the IPAQ (international questionnaire, validated and adapted for the elderly) and obesity by the calculation of Body Mass Index (BMI). For the classification of nutritional status, the PAHO classification (2002) was used. Sociodemographic and economic information (sex, age, schooling, family arrangement, marital status, income perception, occupational situation and family arrangement), information about health conditions and importance of religion were also evaluated. The associations were studied using the Rao-Scott test. Multiple analysis was performed using stepwise / forward logistic regression (RL). All the variables that presented p <0.20 in the univariate analysis and other variables of theoretical relevance were included in the RL model. The statistical program used for data analysis was the statistical program Stata (version 12.0), and for all analyzes the significance level of 5 per cent was used. A prevalence of 12.92 per cent of depressive symptoms was obtained. There was a significant association between SD: sex (OR: 3.44; CI95 per cent : 1.93-6.16), health perception classified as regular (OR: 3.60; CI95 per cent :1.80-7.17) and poor (OR: 9.23, CI95 per cent :3.32-25.66), difficulties in performing one to two basic activities of daily living (OR: 1.80, CI95 per cent : 1.03 - 3,16) or three or more basic activities of daily living (OR: 4.15, CI 95 per cent : 1.72-10.0), were classified as insufficiently active in walking practices (OR 2.38, CI95 per cent : 1.17-3.32) and did not report religion as important in their life (OR: 9.75; CI95 per cent : 2.10-45.14). The incidence of depressive symptoms was 28.6/1,000 patients a year (CI95 per cent : 22.7 - 36.7), significantly associated with: taking between one to four medications (OR: 3.43; CI95 per cent : 1.67 - 7.07) and five or more medications (OR: 81.39, CI95 per cent : 8.42-786.70), have difficulty performing one to two basic activities of daily living (OR:2.0, CI95 per cent : 1.04-3.85) , perception health as poor (OR: 3.85; 95 per cent CI: 1.21-12.26). Irregularly performing physical activities such as walking was also a risk factor associated with depressive symptoms, although the association was borderline (OR: 1.78; CI95 per cent : 0.98 - 3.22). Therefore, there was no significant association between depressive symptoms and obesity, but there was an association of depressive symptoms with walking and other factors that corroborate with the national and international literature

O objetivo geral deste trabalho foi avaliar a presença de sintomas depressivos e as possíveis influências do Diabetes Mellitus tipo I (DM1) na qualidade de vida de adolescentes com esta doença. Para alcançar tal objetivo foram avaliados adolescentes com DM1 (58) e sem DM1 (61) completando um total de 119 adolescentes avaliados; de ambos os sexos. Os locais de coleta de dados foram o Ambulatório de Endocrinologia da Criança e do Adolescente (ECA) do Hospital das Clínicas da Faculdade de Medicina da USP (HCRP-USP) para os adolescentes diabéticos e para os não diabéticos o colégio público regular Escola Municipal de Ensino Fundamental Prof. Raul Machado, no município de Ribeirão Preto-SP. Foram utilizados dois instrumentos para coleta de dados, o The World Health Organization Quality of Life-Bref (Whoqol-bref); instrumento de Qualidade de Vida; e o Inventário de Depressão de Beck; instrumento que avalia sintomas depressivos. Os dados coletados foram organizadas em banco de dados no programa estatístico Stata, versão 12.0, e analisadas a partir de técnicas de estatística descritiva e inferencial. Os resultados desta pesquisa mostraram que, nas avaliações de qualidade de vida, quando não há presença de sintomas depressivos em comparação com o grupo sem diabetes, o grupo de diabéticos apresenta pior qualidade de vida nos domínios físico, social, ambiente e satisfação, todavia, quando há presença destes sintomas, a qualidade de vida é pior nos dois grupos. Conclui-se que o DM1 e a presença de sintomas depressivos, ambos interferem na qualidade de vida dos indivíduos em que acomete, nem sempre de forma igual. Desta maneira, foi possível compreender a importância do olhar ao adolescente com e sem a doença, afim de observar as peculiaridades dos indivíduos nesta fase da vida / The aim of this study was to assess the presence of depressive symptoms and the possible influences of type I diabetes mellitus (DM1) the quality of life of adolescents with this disease. To achieve this goal were evaluated adolescents with type 1 diabetes (58) and without DM1 (61) for a total of 119 adolescents evaluated; of both sexes. Data collection sites were the Endocrinology Clinic of Child and Adolescent (ECA) of the Hospital of the Faculty of Medicine, USP (HCRP-USP) for diabetic patients and nondiabetic patients regular public school Municipal School Elementary Education Prof. Raul Machado, in Ribeirão Preto-SP. Two instruments for data collection were used, The World Health Organization Quality of Life-Bref (WHOQOL-BREF); Quality of Life instrument; and the Beck Depression Inventory; instrument that assesses depressive symptoms. The collected data were organized in a database using Stata, version 12.0, and analyzed from descriptive and inferential statistical techniques. Our results show that in life quality assessments where there is presence of depressive symptoms compared with the group without diabates, the group of diabetics has worse quality of life in the physical, social, environment and satisfaction, however, when there is presence of these symptoms, quality of life is worse in both groups. It is concluded that the presence of DM1 and depressive symptoms, both interfere with the quality of life of individuals in that affects not always equal. In this way it was possible to understand the importance of looking adolescents with and without the disease in order to observe the peculiarities of individuals at this stage of life.

INTRODUÇÃO: Os critérios diagnósticos atuais para as síndromes depressivas não identificam uma parcela dos idosos com sintomatologia depressiva clinicamente significativa. Instrumentos psicométricos específicos para esta população, que sejam rápidos e fáceis de aplicar tornam-se necessários. A partir de instrumentos previamente validados como as escalas GDS e CES-D, e de um consenso de especialistas foi desenvolvida uma escala de 10 itens para avaliar o construto clínico de depressão em pacientes idosos. OBJETIVO: Validação interna de uma nova escala de rastreio de sintomas depressivos em idosos (D10) desenvolvida no Programa Terceira Idade (PROTER), Instituto de Psiquiatria HC FMUSP. MÉTODOS: Uma amostra de conveniência composta por 62 sujeitos foi utilizada para o estudo de validade de critério (validade concorrente). Destes, 44 foram incluídos nos estudos de confiabilidade (consistência interna, estabilidade e equivalência) e de validade de construto (validades convergente e divergente). Todos os participantes incluídos tinham idade 60 anos, não apresentavam doenças médicas graves ou descompensadas, déficits cognitivo e funcional significativos (avaliados, respectivamente, pela M-CIRS, MMSE e B-ADL) e não apresentavam histórico passado ou atual sugestivo de síndrome psicótica. Os diagnósticos foram obtidos pela entrevista estruturada MINI-Plus (seções A, B, D, E, F e P) e a intensidade dos sintomas depressivos mensurados pela MADRS. Outros instrumentos foram utilizados (CAMCOG, IQCODE, CAGE, DUSI-R) no desenho da pesquisa, para reduzir a possibilidade de vieses sistemáticos. A distribuição da amostra foi avaliada pelo Teste Kolgomorov-Smirnov, e os índices de correlação de Pearson e Spearman foram utilizados para aferir a relação entre a D10 e as escalas MADRS e CAGE. A correlação entre os itens da D10 foram analisados pelos coeficientes de Correlação Intraclasse (CCI) e alfa de Cronbach. A acurácia do teste foi investigada pela análise das áreas sob as curvas ROC. RESULTADOS: A amostra (idade média de 72,35; SD=7,05) não apresentou diferenças significativas entre as variáveis sócio-demográficas, econômicas, clínicas, cognitivas e funcionais estudadas (p>0,05). O valor de alfa (consistência interna) manteve-se estável e elevado (=0,84±0,02) e os itens da D10 apresentaram boa equivalência (inter-rater) (rs=0,95, p0,01) e boa estabilidade (intra-rater) (rs=0,95, p0,01). A escala MADRS correlacionou-se significativamente com a D10 (rp=0,86, e rs=081, p0,01), não tendo se correlacionado com a CAGE (p>0,05). Esse achado foi reforçado pela correlação entre a CAGE e a DUSI-R (rp=0,31, p=0,005; e rs=0,29 p=0,01). A nota de corte de 6 pontos na D10 apresentou elevados níveis de sensibilidade (96,2%), especificidade (88,9%), valor preditivo positivo (86,2%), valor preditivo negativo (97%) e acurácia (91,9%). O tempo médio de aplicação do novo instrumento foi de 42±4 segundos. CONCLUSÕES: Os resultados obtidos indicaram que a escala D10 apresentou confiabilidade, validade interna, e acurácia adequadas para ser utilizada como um instrumento de aplicação rápida para o rastreio de sintomatologia depressiva clinicamente significativa em idosos / identify a portion of elderly people with clinically significant depressive symptoms. Specific psychometric instruments for this population with quick and easy application properties are of the essence. Based on previously validated instruments, such as GDS and CES-D scales, and on consensus among specialists, a 10-item scale was developed to assess the clinical depression construct in elderly patients. OBJECTIVES: Internal validation of a scale to screen depressive symptoms in elderly people (D10) developed in the Senior Citizens Program (locally, PROTER), at the Institute of Psychiatry of the HCFMUSP. METHODS: A convenience sample of 62 subjects was used for the criterion validity study (concurrent validity). Of these, 44 were included in the studies of reliability (internal consistency, stability and equivalence) and of the construct validity (convergent and divergent validity). All the participants included in the study were 60 years old, did not present any serious or uncontrolled medical conditions, significant cognitive or functional deficits (evaluated, respectively, through M-CIRS, MMSE and B-ADL), nor past or present history suggestive of psychotic syndrome. Diagnostics were obtained through the MINI-Plus structured interview (sections A, B, D, E, F and P), and the intensity of depressive symptoms through the MADRS. In the research design, other instruments were used (CAMCOG, IQCODE, CAGE, DUSI-R), aimed at reducing the possibility of systematic bias. The sample distribution was evaluated through the Kolgomorov- Smirnov Test, and the Pearson and Spearman correlation indexes were used to verify the relation between the D10 and the MADRS and CAGE scales. The correlation of the D10 items were analyzed through the Intraclass Correlation (ICC) and Cronbach\'s alpha. The test accuracy was investigated through the analysis of the areas under ROC curves. RESULTS: The sample (mean age of 72,35; SD=7,05) did not evidence significant differences in the socio-demographic, economic, clinical, cognitive and functional variables studied (p>0,05). The alpha value (internal consistency) remained stable and elevated (=0,84±0,02), D10 items presented good equivalence (inter-rater) (rs=0,95, p0,01) and good stability (intra-rater) (rs=0,95 p0,01). The MADRS scale correlated significantly with CAGE (p>0,05). This finding was reinforced by the correlation between CAGE and DUSI-R (rp=0,31 p=0,005; and rs=0,29 p=0,01). A cut-off score of 6 points in D10 presented high levels of sensitivity (96,2%), specificity (88,9%), positive predictive value (86,2%), negative predictive value (97%) and accuracy (91,9%). The average application time of the new instrument was 42±4 seconds. CONCLUSIONS: The results obtained indicate that the D10 scale presented adequate reliability, internal validity and accuracy for use as a quick application instrument to screen clinically significant depressive symptoms in the elderly

Introdução: Depressão ou morbidade depressiva, é uma doença mental complexa que inclui diferentes fenótipos e sintomas, com desfechos negativos na saúde. Os diferentes distúrbios psiquiátricos, assim como a presença de sintomas depressivos, têm sido associados a dieta e hábitos alimentares. Objetivos: Investigar a associação entre sintomas depressivos e aspectos relacionados ao estado nutricional e alimentação, em idosos residentes na da Zona Oeste do município de São Paulo. Métodos: O presente estudo é epidemiológico, transversal, de base comunitária, com 2.643 idosos com idade igual ou superior a 60 anos. Foram consideradas como variáveis: a- Dependente: Sintomas Depressivos pela escala proposta pelo Centro de Estudos Epidemiológicos para identificação de sintomas depressivos (CES-D); Variáveis independentes (preditores): Estado nutricional a partir das medidas antropométricas (peso e altura com posterior cálculo do IMC, e circunferência da cintura); Respostas a algumas questões relacionadas ao hábito de consumir determinados alimentos ou grupos de alimentos, e hábito de fazer as refeições diárias. Foram ainda avaliadas as variáveis relacionadas a presença de doenças crônicas (hipertensão, diabetes e hipercolesterolemia); características sócio econômicas e demográficas (critério de Classificação Econômica Brasileira (CCEB). As variáveis foram analisadas por regressão logística binária, adotando significativos os valores de p <0,05. Resultados: Foi encontrada uma prevalência elevada de sintomas depressivos (38%); associaram-se positivamente aos sintomas depressivos o hábito em consumir frutas, feijões, leites e derivados, azeite, água e vinho. Após ajustes pelas variáveis clínicas, socioeconômicas e demográficas, permaneceram significantes no modelo final o hábito em consumir leites e derivados, azeite e vinho; o hábito em realizar o almoços e jantar; relatar a presença de HAS; pertencer ao sexo feminino e estar divorciado ou separado. Conclusões: O presente estudo mostrou a existência de associações significativas entre sintomas depressivos e o hábito em consumir determinados alimentos (leite e derivados, azeite e vinho). Porém tais dados ainda não são totalmente conclusivos para a população brasileira. Novos estudos fazem-se necessários para esclarecer a relação entre o hábito em consumir determinados grupos de alimentos e a chance em desenvolver sintomas depressivos em idosos. / Background: Depression or depressive morbidity is a complex mental disease that includes different phenotypes and symptoms, with negative health outcomes. The different psychiatric disorders, as well as the presence of depressive symptoms, have been associated with diet and eating habits. Aims: To investigate the association between depressive symptoms and aspects related to nutritional status and feeding, of elderly residents from the West Zone of the city of São Paulo. Methods: The present study is a cross-sectional, community-based epidemiological study with 2,643 elderly individuals aged 60 or over. The following variables were considered: a-) Depedemt: Depressive Symptoms by the scale proposed by the Center for Epidemiological Studies to identify depressive symptoms (CES-D); Independent (predictors): Nutritional status from anthropometric measures (weight and height with subsequent calculation of BMI, and waist circumference); Answers to some questions related to the habit of consuming certain foods or food groups, and habit of making daily meals (Brazil, 2006). The variables related to the presence of chronic diseases (hypertension, diabetes and hypercholesterolemia) were also evaluated; Socioeconomic and demographic characteristics (Brazilian Economic Classification, CCEB) (ABEP, 2011). The variables were analyzed by binary logistic regression, adopting significant values of p <0.05. Results: There was found a high prevalence of depressive symptoms (38%); The habit of consuming fruits, beans, milks and derivatives, olive oil, water and wine were positively associated with depressive symptoms. After adjusting for the clinical, socioeconomic and demographic variables, the habit of consuming milk and derivatives, olive oil and wine remained significant in the final model; The habit of holding lunch and dinner; Have HAS; Belong to the female sex and be divorced or separated. Conclusions: The present study showed the existence of significant associations between depressive symptoms and eating habits (milk and dairy products, olive oil and wine). However, these data are not yet fully conclusive for a Brazilian population. New studies are needed to define a relationship between the habit and consumption of food groups and a chance to develop depressive symptoms in the elderly.