Introduction Despite the results of epidemiological and psychometric studies reporting comparable levels of tobacco dependence among males and females, some clinical studies have detected disparities. Some smoking cessation studies based on clinical setting programs reported poorer outcomes among women than men. Methods This retrospective cohort study aimed to compare treatment success and retention between men and women on a smoking cessation program (n = 1,014) delivered at a CAPS-AD unit in Brazil. The psychological intervention lasted 6 weeks for each group of 15 patients. Each patient had to participate in weekly group cognitive-behavioral therapy (CBT) sessions and individual medical appointments during this period. These appointments were focused on the possibility of prescribing pharmacological treatment (i.e., nicotine replacement therapy, bupropion, or nortriptyline) as adjuvants to group therapy. Results The women had lower smoking severity at baseline, more clinical symptoms, and lower prevalence of alcohol and drug use disorders and were older than the men. Females had significantly higher levels of success (36.6% vs. 29.7%) and retention (51.6% vs. 41.4%) than males. Sensitivity analysis showed that female gender was significantly associated with both retention and success, among those without drug use disorders only. Conclusion Depending on the smoking cessation setting (i.e., low and middle-income countries and mental health and addiction care units), females can achieve similar and even higher quit rates than males. Previous drug use disorder was an important confounding variable in the gender outcomes analyses. Future studies should try to replicate these positive smoking cessation effects of CBT-based group therapy plus pharmacotherapy in women.
Objective: This study aimed to analyze the effect of major depressive disorder (MDD) as a risk factor for suicidal ideation in individuals whose ages varied from 11 to 24 years and who were attending educational institutions. Data source: A systematic review was carried out by searching in PubMed and Biblioteca Virtual em Saúde (BVS). Original studies conducted in educational institutions, including individuals whose age varied from 11 to 24 years, in English, Spanish, or Portuguese were included. Data synthesis: Eight studies were selected for the meta-analysis, including 35,443 youths, with an average age of 16.8 years, predominantly female (51.2%), and from middle-income Asian countries (91.6%). An odds ratio of MDD of 3.89 (95%CI 2.46–6.17) for suicide ideation in youth was found. Subgroup analysis showed higher effects in Asia (OR=4.71; 95%CI 3.22–6.89) than Americas (OR=1.71; 95%CI 1.44–2.03). The meta-regression model indicated that younger adolescents (coef=-0.63; 95%CI 1.09–-0.18; p<0.01) and older studies (coef=-0.23; 95%CI 0.039–-0.08; p<0.01) presented higher effects of MDD on suicidal ideation. Conclusions: Early detection and treatment of MDD in youth patients are of utmost importance for preventing suicidal ideation. Educational institutions could play an important role in the early detection and intervention.
Introdução A cefaleia e o transtorno depressivo estão entre as doenças mais incapacitantes do mundo, segundo a Organização Mundial da Saúde. Estudos epidemiológicos e clínicos demonstraram uma associação entre estas duas etiologias, sendo uma associação bidirecional, o que significa que a presença de uma aumenta as chances de desenvolvimento do outra. Objetivo Avaliar a taxa de prevalência internacional de cefaleia no transtorno depressivo. Metodologia Foi realizada uma revisão sistemática da literatura utilizando a estratégia de busca: ("Headache"[Mesh]) AND "Depressive Disorder"[Mesh] nas bases de dados da PUBMED. Não houve restrições de idade, populações, settings, datas e países de origem. Foram selecionados artigos publicados até abril de 2021, em língua inglesa, portuguesa e espanhola. Resultados Nossa estratégia de busca encontrou 275 artigos, dos quais 16 preencheram nossos critérios de inclusão. Quanto ao continente de realização dos estudos, 37.5% foram na América, 37.5% na Ásia e 25% na Europa. Houve uma maior prevalência do gênero feminino com uma proporção de feminino/masculino de 1.45, ressaltando que 25% dos artigos não descreverem os gêneros avaliados. Para o diagnostico de transtorno depressivo 50% dos artigos utilizaram o Manual de Diagnóstico e Estatística dos Transtornos Mentais Quarta Edição e para cefaleia 31.5% utilizaram a International Classification of Headache Disorders Second Edition. A mediana de participantes foi de 605.5, variando de 102 a 64.460. A mediana da prevalência foi de 42.4% variando de 15.6 a 90.4%. Conclusão A alta prevalência encontrada reforça a necessidade de prestar maior atenção a essa comorbidade e gerenciar as cefaleias de forma adequada, além do tratamento para o transtorno depressivo.
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