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Previous issue date: 2017-03-14 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Depression is a highly prevalent disease in the elderly, warranting further
investigation of the factors associated with its occurrence. In addition, exposure to adverse
conditions, especially in childhood, would appear to have an important influence on the
manifestation of this disease. Objective: A cross-sectional study aimed to examine the
relationship between maltreatment in childhood with depression in the elderly, based on data
originating from the research, Epidemiological and Clinical Study of the Elderly, enrolled in
the health strategy of Porto Alegre (EMI-SUS). Methods: A random sample comprised of 449
elderly participants, living in low socioeconomic conditions, and enrolled in the Family
Health Strategy (FHS) program in the city of Porto Alegre. The prevalence of adverse
childhood experiences was estimated, as reported by the elderly and measured using the
Childhood Trauma Questionnaire (CTQ), with the aim of examining associations with
sociodemographic factors and current geriatric depression, obtained from the 15-item
Geriatric Depression Scale (GDS-15). Results: The sample was predominantly
white/Caucasian (67.2%), female (64.1%), and aged 65-75 years (46.1%). The majority had a
personal income of less than one minimum salary (57.7%) or had no income (8%), and had a
very low formal education level of 4 years or less (35.4%), with a significant number being
illiterate (25.8%). Depression was more prevalent in the elderly of a more advanced age
(31.6%), divorced (33.2%), black (33.9%), illiterate (39.7%), and with no income (44.1%).
Many participants reported experiences of maltreatment during childhood, having suffered
some form of abuse or neglect (35.7%). Higher frequencies of emotional neglect (47.3%) and
emotional abuse (43.5%) were observed in the reports. The odds ratios with 95% confidence
intervals for the maltreatment subtypes were: Emotional Neglect [2.822 (1.698-4.692)],
Emotional Abuse [2.252 (1.351-3.754)], Physical Neglect [1.912 (1.179-3.103)], and Physical
Abuse [1.754 (1.076-2.861)], all of which were independently associated with current
geriatric depression. Severe depression was significantly associated with Emotional Abuse
[4.193 (1.752-10.036)], Emotional Neglect [3.543 (1.489-8.429)], and Physical Abuse [3.014
(1.245-7.296)]. In the adjusted model considering the overlapping of maltreatment, a rising
odds ratio was found for current geriatric depression in which it was significantly associated
with two [3.298 (1.600-6.796)], three 3.108 (1.359-7.111), four [3.813 (1.643-8.933)] and five
[4.394 (1.300-14.853)] types of maltreatment experience. Conclusion: The main findings
revealed that individuals presenting current geriatric depression more frequently reported
having suffered physical and emotional abuse and/or neglect. Moreover, there is evidence that
emotional abuse and neglect, coupled with an overlapping experience of maltreatment,
contributed to the severity of depression. It is important to note that these elements were
found within the context of a low-income, low-education level, homogeneous and multiethnic
population. / Introdu??o: examinar os fatores que est?o associados ? manifesta??o da depress?o ampara-se
no fato de ela ser uma doen?a de alta preval?ncia em idosos. Al?m disso, a exposi??o ?s
situa??es adversas, principalmente no per?odo da inf?ncia, parece ter importante influ?ncia na
manifesta??o da depress?o. Objetivo: estudo transversal que visa examinar a rela??o entre
maus-tratos na inf?ncia com depress?o em idosos, a partir do banco de dados originado pelo
Estudo Epidemiol?gico e Cl?nico dos Idosos cadastrados na estrat?gia de sa?de de Porto
Alegre (EMI-SUS). M?todo: a amostra ? aleat?ria e composta por 449 idosos cadastrados na
Estrat?gia Sa?de da Fam?lia (ESF) do munic?pio de Porto Alegre e que vivem em baixa
condi??o socioecon?mica. Foi estimada a preval?ncia de situa??es adversas sofridas na
inf?ncia, reportada por idosos e medida atrav?s do Question?rio de Traumas Infantis (CTQ),
com o intuito de examinar associa??es com fatores sociodemogr?ficos e depress?o geri?trica
atual, obtida atrav?s da Escala de Depress?o Geri?trica de 15 itens (GDS-15). Resultados: a
amostra foi prevalentemente feminina (64,1%), com idade entre 65 e 75 anos (46,1%), de
brancos/caucasianos (67,2%). A maioria detinha n?vel de educa??o formal muito baixa, de 4
anos ou menos (35,4%), com uma parcela significativa de analfabetos (25,8%). Quanto ?
renda, 57,7% da amostra recebia valor menor do que 1 (um) sal?rio m?nimo ou n?o tinha
nenhuma renda (8%). A depress?o foi mais prevalente em idades mais avan?adas (31,6%),
negros (33,9%), analfabetos (39,7%), sem renda (44,1%) e divorciados (33,2%). Em rela??o
?s experi?ncias de maus-tratos, muitos sujeitos relataram ter sofrido algum tipo abuso ou
neglig?ncia durante a inf?ncia (35,7%). Observaram-se frequ?ncias mais altas nos relatos de
Neglig?ncia Emocional (47,3%) e Abuso Emocional (43,5%). Os subtipos de maus-tratos
apresentaram odds ratio e IC 95%: Neglig?ncia Emocional [2.822 (1.698-4.692)], Abuso
Emocional [2.252 (1.351-3.754)], Neglig?ncia F?sica [1.912 (1.179-3.103)], Abuso F?sico
[1.754 (1.076-2.861)], sendo que todos foram associados independentemente com a depress?o
geri?trica atual. A depress?o grave foi associada de forma significativa com Abuso Emocional
[4.193 (1.752-10.036)], Neglig?ncia Emocional [3.543 (1.489-8.429)] e Abuso F?sico [3.014
(1.245-7.296)]. Na sobreposi??o de maus-tratos, no modelo ajustado, uma raz?o de chance
crescente de depress?o geri?trica atual foi encontrada, em que foram associadas de forma
significativa para dois [3.298 (1.600-6.796)], tr?s 3.108 (1.359-7.111), quatro [3.813 (1.643-
8.933)] e cinco [4.394 (1.300-14.853)] experi?ncias de maus-tratos. Uma rela??o crescente
entre sobreposi??o de maus-tratos e depress?o foi observada nos grupos com depress?o grave,
sendo significativos os resultados da sobreposi??o de tr?s [4.570 (1.286-16.235)] e de quatro
[5.666 (1.602-20.034)] tipos de experi?ncias de maus-tratos Conclus?es: os principais
achados mostram que indiv?duos que apresentaram depress?o geri?trica atual relataram ter
sofrido mais abuso e/ou neglig?ncia f?sica e emocional. Ademais, h? ind?cios que abuso e
neglig?ncia emocional em conjunto com a sobreposi??o de experi?ncia de maus-tratos t?m
contribu?do para a severidade da depress?o. Ressalta-se que esses elementos foram
encontrados dentro de um contexto relevante, de uma popula??o homog?nea, multi?tnica, de
baixa renda e de baixa escolaridade
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/7602 |
| Date | 14 March 2017 |
| Creators | Novelo, Marta |
| Contributors | Argimon, Irani Iracema de Lima |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, Brasil, Instituto de Geriatria e Gerontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 4438661476953179033, 500, 500, 500, 600, 2296420844541114010, -969369452308786627, 2075167498588264571 |
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