The relationships among suicidal ideation, sleep, depression, anxiety, and effects on epilepsy require more research. Objective: The aim of this study was to estimate the prevalence of suicidal ideation in outpatients with epilepsy, and relate this to sleep quality, daytime sleepiness, depression, and anxiety. Method: Ninety-eight non-selected patients were evaluated. The subjects were classified as "suicidal ideators" or "non-ideators", based on their response to item 9 of the Beck Depression Inventory. Results: The prevalence of suicidal ideation was 13.3% (x 2 =50.46, p,0.001). The differences between cases with or without suicidal ideation were statistically significant in relation to sleep quality (p=0.005) and symptoms of depression (p=0.001) and anxiety (p=0.002). Conclusion: Our results revealed that depression and anxiety were associated with sleep quality, daytime sleepiness, and suicidal ideation and that depression and sleep disturbance were good predictors of suicide in subjects with epilepsy.Keywords: epilepsy, suicidal ideation, depression, anxiety, sleep disorders, sleep quality, predictors. RESUMO A relação entre ideação suicida, sono, depressão e ansiedade, bem como as implicações da epilepsia nessa relação ainda exigem mais pesquisa. Objetivo: Estimar a prevalência de ideação suicida em pacientes ambulatoriais com epilepsia e relacioná-la com qualidade do sono, sonolência diurna, depressão e ansiedade. Método: Foram avaliados 98 pacientes não-selecionados. Os indivíduos foram classificados como tendo ou não ideação suicida, com base nas respostas ao item 9 do Inventário Beck de Depressão. Resultados: A prevalência de ideação suicida foi de 13,3% (x 2 =50,46; p,0,001). As diferenças entre os casos com e sem ideação suicida foram estatisticamente significativas em relação à qualidade do sono (p=0,005), sintomas depressivos (p=0,001) e ansiosos (p=0,002). Conclusão: Depressão e ansiedade mostraram associação com qualidade do sono, sonolência diurna e ideação suicida; depressão e distúrbios do sono foram bons preditores de suicídio em epilepsia.Palavras-chave: epilepsia, ideação suicida, depressão, ansiedade, distúrbios do sono, qualidade do sono, preditores.Suicide and overall mortality are higher in patients with epilepsy (PWE) than in the general population. We must be cautious in the study of comorbidity. Prevalence rates of psychiatric comorbidities require more studies and more appropriate therapeutic 1,2,3,4,5,6,7,8,9 . However, knowledge concerning suicide and its ideation in PWE is still limited. Some authors have reported specific risk factors for suicide in epilepsy 8 , such as patients being relatively young (25-49 years), male sex, early onset of epilepsy, temporal lobe seizures, the presence of brain injuries, difficulty in controlling epileptic seizure episodes, and psychosocial and occupational difficulties 3 . Another important association is related to suicidal thoughts, behavior, and sleep disorders. The study of this association has advanced in recent years,
The study was a narrative review on the mental health of children and adolescents during a COVID-19 pandemic. A search was performed in the PubMed, BVS and Google Scholar databases, between April and June 2020. The studies revealed greater psychological distress due to social isolation, increased family conflicts and violence between parents and children. The closure of schools, lack of social interaction, feelings of uncertainty and fear in the face of a pandemic also contribute to the emergence of anxiety and stress symptoms in families. The resources of the Internet and social media can be tools of psychosocial support to families during quarantine, enabling therapeutic practices, information and contact between peers; minimizing symptoms of stress, anxiety and depression. Public policies are urgent and demand innovation and new technologies applied to families' mental health care.
-This study presents the performance of 39 cases of myotonic dystrophy on Kohs' blocks test (21 females and 18 males, age range from 9 to 70 years). On this test, the patients have to reproduce figures from models previously showed to them. Some of the patients had some kind of professional activity, while others had never exerted a professional occupation. The patients denoted considerable difficulty to perform the test. Some cases constructed entirely different figures in comparison to the presented drawings, translating visuo-spatial and constructional disabilities. The performance was insufficient in 71.4 % of the cases. These cases solved less than 50% of the test. The levels of analysis and synthesis were severely impaired. A total of 18 cases got less than 10 points, not reaching 20% of the test. The results showed the sensitivity of this test in detecting visuo-spatial impairment in myotonic dystrophy.KEY WORDS: myotonic dystrophy, psychological tests, Kohs' blocks.O teste dos cubos de Kohs como importante instrumento para investigar as alterações visuo-espaciais da distrofia miotônica: I. Análise quantitativa e qualitativa RESUMO -Foram avaliados 39 casos de distrofia miotônica a partir do desempenho no teste dos cubos de Kohs. Havia 21 casos femininos e 18 masculinos, idade variando de 9 a 70 anos e diferentes níveis educacionais (do primário ao superior). Alguns encontravam-se ativos profissionalmente, enquanto outros nunca exerceram uma ocupação profissional. Os pacientes denotaram considerável dificuldade na execução deste teste que é instrumento que se apresenta fundamentalmente por reprodução de figuras. Houve casos que construíram figuras com formas bem diferentes dos desenhos apresentados. O desempenho foi insuficiente em 71,4 % dos casos, os quais não conseguiram resolver 50% do teste. Muitas das reproduções fugiram ao padrão correto, traduzindo comprometimento visuo-espacial pela grave distorção em comparação com a figura modelo. Os níveis de análise e síntese estavam comprometidos de forma importante. Dentre os pacientes, 18 casos não alcançaram os 10 pontos, dos 133 possíveis, não realizando sequer 20% do teste. Os resultados comprovaram a sensibilidade deste teste em detectar comprometimento visuo-espacial na distrofia miotônica. PALAVRAS-CHAVES: distrofia miotônica, testes psicológicos, cubos de Kohs, alterações visuo-espaciais.
RESUMO -Realizou-se estudo longitudinal das alterações cognitivas de 12 casos de distrofia miotônica comparando os resultados de dois exames com intervalo de tempo entre eles, pois em uma primeira avaliação detectaram-se alterações vísuo-espaciais e construtivas que poderiam evoluir ou não com o passar do tempo. Foram aplicados os seguintes instrumentos de medidas psicológicas: matrizes progressivas de Raven (escala especial forma caderno para as crianças, adolescentes e adultos com dificuldades cognitivas graves e escala geral para adolescentes e adultos sem dificuldades cognitivas graves), Wechsler (escala para crianças, subtestes semelhanças e números), cubos de Kohs e Piaget-Head. A seleção dos testes e respectivas escalas e formas teve como referencial as entrevistas psicológicas realizadas caso a caso. Estes instrumentos com respectivos resultados foram comparados em cada caso através de duas avaliações, com um intervalo de aproximadamente três anos e meio entre a primeira e a segunda avaliações de cada teste. Quanto ao desempenho nos testes, verificamos: (a) melhor desempenho estatisticamente significante na segunda avaliação pelo teste dos Cubos de Kohs, porém tanto o primeiro quanto o segundo exame denotaram desempenhos bastante insuficientes; (b) leve queda do desempenho no teste de Head 1-3; (c) leve melhora nos demais testes. PALAVRAS-CHAVE: distrofia miotônica, miotonia atrófica, exame psicológico, avaliação longitudinal. Longitudinal psychologie study in myotonic dystrophySUMMARY -The authors studied in two occasions a group of 12 patients with myotonic dystrophy in a mean interval of three years and a half between the examinations. The neuro -psychological battery included the following tests: Raven's progressive matrices (coloured and general scales) , Wechsler children intelligence scale (WISC), Kohs' blocks and Piaget-Head. 50% of the patients had better scores on the second examination on RCPM, 81.89% on WISC-digit span, 63.67% on WISC-numbers, 44.44% on Piaget-Head 2 and 60% on Kohs' blocks. However, on Piaget-Head 1-3, the majority had worse results (87.56%) with statistical significative difference (p <0.05). Though the scores from Kohs' blocks were better in 60% of the patients with p< 0.05, we have to consider that 60% had 0 point on first examination being their scores a little better on second one. This is enough to result on statistical significative difference, however, very low if compared to normal subjects.
Considering the tendency of improved life expectancy worldwide, women will, increasingly, experience the climacteric during the next years. A variety of biopsychosocial changes are experienced by women throughout the climacteric. As age progresses, ovarian functions decrease until the onset of menopause. With decreased levels of estradiol and progesterone, a sum of neuropsychic symptoms, such as insomnia, irritability, attention deficit and memory, anxiety and depression, become common complaints in this stage of women's life. Among them, depression is undoubtedly a global mental health problem. The aim of the present review was to present selected studies between 2007 and 2017, based on the Medline and Web of Science databases, and Academic Google, on climacteric and its main symptoms, highlighting neuropsychic symptoms, and, especially, depression. As one of the most common symptoms during climacteric, especially during menopause, depression leads to decreased motivation and productivity, increases the number of visits to health clinics, the risk of suicidal ideation and suicide itself. Studies on the prevalence and incidence of climacteric depression are of great use in the maintenance of mental health of women and in the technical qualification of outpatient clinics for women in the climacteric.
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