Introdução: A desesperança encontra-se amplamente associada com depressão maior e risco de suicídio. O suicídio, por sua vez, é um problema de saúde pública que está associado a uma diversidade de fatores e contextos econômicos, sociais e emocionais. No Brasil, a ocorrência de suicídio parece se relacionar diretamente com situações de perda, frustrações e sofrimento emocional, como a situação de abortamento na vida da mulher. Objetivos: este estudo tem como objetivos identificar desesperança em mulheres que viveram/provocaram abortamento; avaliar depressão maior; verificar a associação entre ocorrência de abortamento espontâneo ou provocado e depressão e desesperança. Método: este estudo foi composto por duas fases. Na primeira fase, foi verificado o prontuário de 162 mulheres que tiveram diagnóstico de abortamento e participaram do projeto anterior \"Culpa, ansiedade e depressão na vivência do abortamento provocado\", sendo que, destas 144 tinham vivido abortamento espontâneo e 18, abortamentos provocados. Nessa fase foram analisadas entrevista semidirigida; Primary Care Evaluation of Mental Disorders (PRIME-MD) e Escala de Desesperança de Beck (BHS). Após uma média de tempo de 95,75 meses da ocorrência do abortamento, foi realizado contato telefônico com as 162 mulheres, visando convidá-las a participar da segunda fase; 12 mulheres aceitaram retornar. Foram aplicados os seguintes instrumentos: entrevista semidirigida, o PRIME-MD e BHS. Foi realizada análise quantitativa e qualitativa dos dados, os quais foram analisados pela técnica de análise temática e posteriormente foi utilizado o programa IBM SPSS Statistics Standard Edition. O nível de significância utilizado foi p < 0,05. Também foi realizada analise qualitativa dos discursos das mulheres que compareceram na segunda fase deste estudo. Resultados: constatou-se que 14,6%(n=21) das mulheres que sofreram abortamento espontâneo apresentaram alto nível de desesperança (índice <= 9) e 30,6%(n=44) apresentaram diagnóstico de depressão maior. Desta forma, foi observada associação significativa entre alto nível de desesperança e diagnóstico depressivo em mulheres com abortamento espontâneo (p=0,03). Entre as mulheres que relataram abortamento provocado, contatou-se que 27,8% (n=5) apresentaram altos índices de desesperança e 55,6%(n=10) foram diagnosticadas com depressão maior. Ao associar as duas variáveis, não foi encontrada significância estatística (p=0,9). Os resultados da segunda fase revelaram que 2 mulheres encontravam- se com alta desesperança, sendo que uma referiu abortamento espontâneo e a outra, provocado, ambas também tinham diagnóstico de depressão maior. Conclusão: foi constatado alto nível de sofrimento emocional e de desesperança associado com a situação do abortamento independente de sua natureza, se espontânea ou provocada. Foi observada associação estatística significativa entre depressão e desesperança entre as mulheres que vivenciaram abortamento espontâneo. Nas avaliações da segunda fase, constatou-se que o sofrimento de algumas mulheres permanecia atual, independente do tempo decorrido ou do tipo do abortamento / Introduction: Hopelessness is widely associated with Major Depression and suicide risk. The suicide, on the other hand, is a public health problem that may be associated with economic, social and emotional factors. In Brazil, the ocurrence of suicide seems to be directly related to situations involving loss, frustrations and emotional distress, such as the abortion situation in woman\'s life. Objectives: This study aims to identify hopelessness in women who have received abortions or miscarriage diagnosis; to evaluate major depression; to verify the association between miscarriage, abortion; depression and hopelessness. Method: This study was composed of two phases. In the first phase, it was verified the medical records of 162 women who had a diagnosis of abortion and participated in the previous Project \"Guilt, anxiety and depression in the experience of induced abortion\". Of these, 144 had a miscarriage and 18 had a induced abortion. For this phase, a semidiriged interwiew; Primary Care Evaluation of Mental Disorders (PRIME-MD) and Beck`s Hopelessness Scale (BHS) was analyzed. In the second phase, after an average time of 95,75 months from the abortion, a telephone call was made to the 162 women in order to invite them to participate at this time; twelve women agreed to return to the second phase of this study. The following instruments were applied: semi-directed interwiew, PRIME-MS and BHS. Quantitative and qualitative analysis was performed. The data were analyzed by the thematic analysis technique and later using the IBM SPSS Statistics Standard Edition. The significance level was p < 0,05. A qualitative analysis of the discourses of the women who attended the second phase was also performed. Results: It was found that 14,6% (n=21) of the women who suffered miscarriage had a high level of hopelessness (índex <= 9) and 30,6% (n=44) presented a diagnosis of major depression. Statistical significance was observed between high level of hopelessness and depressive diagnosis in women with miscarriage (p=0,03). Among women reporting induced abortion, 27,8% (n=5) had high rates of hopelessness and 55,6% (n=10) were diagnosed with major depression. When the two variables were associated, no statistical significance was found (p=0,9). The results of the second phase revealed that 2 women presented a high level of hopelessness, 1 that reported miscarriage and 1 that reported induced abortion. Both had a diagnosis of Major Depression. Conclusion: It was observed a high level of emotional distress associated with the abortion experience regardless of its natures, whether spontaneous or induced. There were There were high rates of hopelessness among women who experienced abortion, whether spontaneous or induced; and a statistically significant association was found between depression and hopelessness among women who experienced spontaneous abortion. In the evaluations of the second phase it was found that the suffering of some women remained current, regardless of the time elapsed or the type of abortion

Introdução: A desesperança encontra-se amplamente associada com depressão maior e risco de suicídio. O suicídio, por sua vez, é um problema de saúde pública que está associado a uma diversidade de fatores e contextos econômicos, sociais e emocionais. No Brasil, a ocorrência de suicídio parece se relacionar diretamente com situações de perda, frustrações e sofrimento emocional, como a situação de abortamento na vida da mulher. Objetivos: este estudo tem como objetivos identificar desesperança em mulheres que viveram/provocaram abortamento; avaliar depressão maior; verificar a associação entre ocorrência de abortamento espontâneo ou provocado e depressão e desesperança. Método: este estudo foi composto por duas fases. Na primeira fase, foi verificado o prontuário de 162 mulheres que tiveram diagnóstico de abortamento e participaram do projeto anterior \"Culpa, ansiedade e depressão na vivência do abortamento provocado\", sendo que, destas 144 tinham vivido abortamento espontâneo e 18, abortamentos provocados. Nessa fase foram analisadas entrevista semidirigida; Primary Care Evaluation of Mental Disorders (PRIME-MD) e Escala de Desesperança de Beck (BHS). Após uma média de tempo de 95,75 meses da ocorrência do abortamento, foi realizado contato telefônico com as 162 mulheres, visando convidá-las a participar da segunda fase; 12 mulheres aceitaram retornar. Foram aplicados os seguintes instrumentos: entrevista semidirigida, o PRIME-MD e BHS. Foi realizada análise quantitativa e qualitativa dos dados, os quais foram analisados pela técnica de análise temática e posteriormente foi utilizado o programa IBM SPSS Statistics Standard Edition. O nível de significância utilizado foi p < 0,05. Também foi realizada analise qualitativa dos discursos das mulheres que compareceram na segunda fase deste estudo. Resultados: constatou-se que 14,6%(n=21) das mulheres que sofreram abortamento espontâneo apresentaram alto nível de desesperança (índice <= 9) e 30,6%(n=44) apresentaram diagnóstico de depressão maior. Desta forma, foi observada associação significativa entre alto nível de desesperança e diagnóstico depressivo em mulheres com abortamento espontâneo (p=0,03). Entre as mulheres que relataram abortamento provocado, contatou-se que 27,8% (n=5) apresentaram altos índices de desesperança e 55,6%(n=10) foram diagnosticadas com depressão maior. Ao associar as duas variáveis, não foi encontrada significância estatística (p=0,9). Os resultados da segunda fase revelaram que 2 mulheres encontravam- se com alta desesperança, sendo que uma referiu abortamento espontâneo e a outra, provocado, ambas também tinham diagnóstico de depressão maior. Conclusão: foi constatado alto nível de sofrimento emocional e de desesperança associado com a situação do abortamento independente de sua natureza, se espontânea ou provocada. Foi observada associação estatística significativa entre depressão e desesperança entre as mulheres que vivenciaram abortamento espontâneo. Nas avaliações da segunda fase, constatou-se que o sofrimento de algumas mulheres permanecia atual, independente do tempo decorrido ou do tipo do abortamento / Introduction: Hopelessness is widely associated with Major Depression and suicide risk. The suicide, on the other hand, is a public health problem that may be associated with economic, social and emotional factors. In Brazil, the ocurrence of suicide seems to be directly related to situations involving loss, frustrations and emotional distress, such as the abortion situation in woman\'s life. Objectives: This study aims to identify hopelessness in women who have received abortions or miscarriage diagnosis; to evaluate major depression; to verify the association between miscarriage, abortion; depression and hopelessness. Method: This study was composed of two phases. In the first phase, it was verified the medical records of 162 women who had a diagnosis of abortion and participated in the previous Project \"Guilt, anxiety and depression in the experience of induced abortion\". Of these, 144 had a miscarriage and 18 had a induced abortion. For this phase, a semidiriged interwiew; Primary Care Evaluation of Mental Disorders (PRIME-MD) and Beck`s Hopelessness Scale (BHS) was analyzed. In the second phase, after an average time of 95,75 months from the abortion, a telephone call was made to the 162 women in order to invite them to participate at this time; twelve women agreed to return to the second phase of this study. The following instruments were applied: semi-directed interwiew, PRIME-MS and BHS. Quantitative and qualitative analysis was performed. The data were analyzed by the thematic analysis technique and later using the IBM SPSS Statistics Standard Edition. The significance level was p < 0,05. A qualitative analysis of the discourses of the women who attended the second phase was also performed. Results: It was found that 14,6% (n=21) of the women who suffered miscarriage had a high level of hopelessness (índex <= 9) and 30,6% (n=44) presented a diagnosis of major depression. Statistical significance was observed between high level of hopelessness and depressive diagnosis in women with miscarriage (p=0,03). Among women reporting induced abortion, 27,8% (n=5) had high rates of hopelessness and 55,6% (n=10) were diagnosed with major depression. When the two variables were associated, no statistical significance was found (p=0,9). The results of the second phase revealed that 2 women presented a high level of hopelessness, 1 that reported miscarriage and 1 that reported induced abortion. Both had a diagnosis of Major Depression. Conclusion: It was observed a high level of emotional distress associated with the abortion experience regardless of its natures, whether spontaneous or induced. There were There were high rates of hopelessness among women who experienced abortion, whether spontaneous or induced; and a statistically significant association was found between depression and hopelessness among women who experienced spontaneous abortion. In the evaluations of the second phase it was found that the suffering of some women remained current, regardless of the time elapsed or the type of abortion

Background: Links between later life depression (LLD) and adverse health outcomes are well-documented, with mental ill-health in rural older adults highlighted as a priority area for health care policy. In working age adults, models of depression show that specific psychological factors (e.g. hopelessness, neuroticism, extraversion and insecure attachment) interact with life stress to increase risk of depression. In older adults, however, the direct relationship between depression and hopelessness is inconsistently replicated. In addition, there is little evidence regarding how psychological factors interact with vulnerability to depression in older adults; and whether these factors act in the same manner as they do in working age adults. Objectives: A systematic review was carried out in order to determine the strength of the depression-hopelessness relationship, and the influence of personality traits (neuroticism/ extraversion) and insecure attachment (anxious/ avoidant) on this relationship. Next, an exploratory study was carried out to determine whether there was a direct relationship between depression and hopelessness in rural older adults living in the community and, secondly, whether this relationship was indirectly influenced by specific psychological factors (e.g. neuroticism, extraversion, and attachment styles). Methods: The systematic review was carried out using several databases (Psychinfo, Science Direct, EBCOS, Cohrane Library, PROSPERO, WEBCAT and Google Scholar). Studies relating to the variables of interest, meeting inclusion and exclusion criteria, were reviewed and evaluated for methodological biases. The pilot study asked older adults (N = 58) living in a remote and rural region to complete and return a packet of self-report questionnaires (Big Factor Inventory-10, Experiences in Close Relationships, Depression, Anxiety and Stress Scale, and the Beck Hopelessness Scale). Results: The systematic review identified twenty-one studies; four examining the depression-hopelessness relationship and seventeen investigating the effects of neuroticism, extraversion and insecure attachment styles on wellbeing, depression and/ or hopelessness. Findings from the pilot showed a direct relationship between depression and hopelessness in rural community dwelling older adults, with only neuroticism indirectly influencing this relationship. Conclusions: The systematic review suggests that it is not possible, as yet, to draw robust conclusions from the existing evidence base regarding the influence of psychological variables on depression and hopelessness in older adults. The findings were particularly sensitive to methodological limitations (e.g. variability between sampling methods and small effect sizes). Despite this, studies suggest some evidence for attachment and personality influencing on the depression-hopelessness relationship. Likewise, findings from the pilot study are limited by the small sample size and cross-sectional nature of the data. Preliminary findings, however, suggest that neuroticism, and not beliefs about insecure attachment, strengthens the relationship between depression and hopelessness in non-clinical, rural older adults. These findings are consistent with research on working age adults and could, potentially, represent an emerging relationship in non-clinical older adults. Further research, however, is required as to whether the same patterns are observed in clinical populations.