Advances in cancer research and therapy have improved prognosis and the quality of life of many patients. However, previous epidemiological studies in oncologic patients
Background and Objectives: Although there is a growing impact of psychiatric and depressive disorders in cancer patients, literature on the idiosyncrasies of antidepressants (ADs) used in those conditions and their interactions with antineoplastic agents (ANs) is scarce. Sharing the same biotransformation pathways enhances the risk of drug interaction between ADs and ANs, specifically when compounds are inducers, inhibitors or substrates of cytochrome P450 (CYP 450). In cancer patients, such drug interactions may result in less efficacy of the drug and/or increase of their side effects. Therefore, the choice of AD should be cautious (safe and effective) and well supported. The main purpose of this review was to analyze the individual pharmacokinetic properties of the most used ADs and ANs in order to summarize the risk of possible drug interactions between them, anticipating the consequences of their coadministration. Methods: The authors reviewed books and PubMed online articles published in the last 6 years. Results: Most of the ANs are subject to transformation by CYP 450 3A4 and their coadministration with ADs, that have inhibitory properties of this CYP isoform, such as fluoxetine, sertraline, paroxetine and fluvoxamine, may result in the loss of the AN’s efficacy or higher toxicity. Conclusion: Among the ADs, escitalopram, citalopram, venlafaxine, mirtazapine and milnacipran stand out for their weak CYP 450 inhibitory potential and their safety profile in those patients.
IntroductionDepression is one of the most common health issues impacting the university student population. The Patient Health Questionnaire (PHQ-9) is a short measure that has the potential to serve as a dual-purpose instrument that establishes depressive disorder diagnoses as well as grades the depressive symptom severity.ObjectivesThe current study was designed to study the psychometric properties of a Portuguese version of the PHQ-9 in a sample of university students.AimsSpecifically, we examined the internal reability and convergent validity of the measure.MethodsThe English language of the PHQ-9 was translated into Portuguese. The process involved back-translation, crosscultural adaptation, field testing of the pre-final version, as well as final adjustments. A sample of university students completed the PHQ-9, the Hospital Anxiety and Depression Scale (HADS) and the Beck Depression Inventory (BDI).ResultsComplete data were obtained from 1241 participants. The mean age of the participants was 23.81 years (SD = 4.87) and 75.3% of them were females. The mean PHQ-9 score was 4.15 (SD = 4.05). The Portuguese version of the PHQ-9 had satisfactory internal consistency (Cronbach's alpha = 0.86) and showed moderate convergent validity with the HADS anxiety (r = 0.61; p < 0.01) and HADS depression (r = 0.59; p < 0.01), and strong convergent validity with the BDI (r = 0.85; p < 0.01).ConclusionsThe PHQ-9 has good psychometric properties amongst Portuguese university students. Implications for using the measure as an assessment instrument in the university setting are discussed.
Depression is often overlooked in oncology practice. Depressive module PHQ-9 was not studied in Portuguese cancer patients, despite its brevity and comparable psychometric proprieties to other depression scales. Which are the psychometric properties of the Portuguese version of the PHQ-9 for use with women with breast cancer? Reliability, sensitivity to change and the construct validity will be studied. The purpose of this study is to assess the psychometric properties of the Portuguese version of the PHQ-9 for use with women with breast cancer. This study intends to evaluate the reliability, the sensitivity to change and the construct validity of the PHQ-9 in a Portuguese Breast Cancer women sample. It was reproduced a principal component analysis and explored the reliability and validity of the questionnaire. The validation used a sample of 63 Portuguese women with breast cancer. A test-retest was conducted in 45 women, after 8 weeks. Construct validity was analyzed. PHQ-9 scores ranged from 0-27, with a mean score of 4,92 (SD= 4,63). The scale presented adequate internal consistency (α = .86) and test retest reliability (ICC= .87). It also presented good construct validity, as overall scores and severity levels were strongly associated with functional and symptoms subscales. The principal component analysis explains 48.42% of the variance. The validation process of the Portuguese PHQ-9 version shows metric properties similar to those in international studies, suggesting that it measures the same constructs, in the same way, as the original version. Data provided evidence for the validity of the PHQ-9 as a brief measure of depression severity in Portuguese women with breast cancer.
The present study examines a new factor structure and the convergent validity of the Portuguese version of the Patient Health Questionnaire-9 (PHQ-9) with college students. This measure has been used to evaluate depressive symptoms in adults. The total sample included 958 college students. Data were collected from a Web-based survey carried out in schools forming the Polytechnic Institute of Coimbra. Students completed the PHQ-9 and Hospital Anxiety and Depression Scale (HADS) and Brief Symptom Inventory (BSI) subscales as convergent measures. Results pointed to good fit of a second-order factor model with three first-order factors (somatic, cognitive and affective dimensions of depression). Strong positive correlations were found between PHQ-9 scores and HADS depression and BSI depression subscales. Our findings reinforce the PHQ-9 as a valid tool in higher education settings. Future studies should re-examine the dimensional structure of the tool considering its implications for the clinical interpretation of the measure.
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