A b s t r a c t Objective: To determine the point prevalence of depressive disorders in medical inpatients, to identify related sociodemographic and medical factors and to evaluate the psychotropic treatment given. Method: A cross-sectional study identifying the prevalence of depressive disorders and related factors combined with a prospective longitudinal study evaluating the psychopharmacological treatment were conducted. Medical inpatients, aged 18 years or older, presenting suitability to be interviewed and giving written informed consent were selected. The sample was composed of 125 subjects. The following instruments were used: a sociodemographic questionnaire; the Mini International Neuropsychiatric Interview; and the Beck Depression Inventory. Data related to medical, personal and family histories of psychiatric disorders and psychotropic use were collected by interview and from patient charts. The study took place at the Hospital Santa Isabel, in Blumenau, located in the state of Santa Catarina, Brazil, from January to July of 2002. Results: The prevalence of depressive disorders was 26%. The factors that correlated with depressive disorders were being female, having an income lower than 3 times the minimum wage, having a personal history of depressive disorders, using psychotropic drugs, scoring higher than 13 on the Beck Depression Inventory and having been referred for a psychiatric consultation (p < 0.05). Only 43.8% of the individuals with depressive disorders received antidepressants. Most of the depressed patients were being treated with benzodiazepines (62.5%). The most frequently prescribed drugs were diazepam and fluoxetine. Conclusions: Approximately one-quarter of the medical inpatients had depressive disorders. However, antidepressants were prescribed for less than half of them. Women with a history of depression, using benzodiazepines and having a low income presented significantly higher rates of depressive disorders. Physicians should suspect depression in patients presenting such characteristics.Keywords: Depressive disorder; Hospitals, general; Length of stay; Prevalence; Psychotropic drugs Resumo Objetivo: Identificar a prevalência de transtornos depressivos em pacientes internados em enfermarias clínicas de um hospital geral, avaliar o tratamento psicofarmacológico recebido e detectar fatores sociodemográficos e clínicos associados. Método: Realizou-se um estudo observacional transversal identificando a prevalência de transtornos depressivos e fatores associados juntamente com estudo longitudinal prospectivo avaliando o tratamento psicofarmacológico recebido durante a internação. Foram selecionados pacientes com mais de 18 anos, que apresentavam condições para a entrevista e que consentiram. A amostra foi composta por 125 pessoas. Aplicaram-se os seguintes instrumentos: questionário com variáveis sociodemográficas; coleta de informações sobre história médica, psiquiátrica e familiar; questionário sobre uso de psicofármacos; Mini International Neuropsychiatric Interview; e Inventário ...
IntroductionSeveral studies have shown that ketamine, an antagonist of NMDA receptors, represents a promising alternative in the treatment of depression. The therapeutic use of ketamine, commonly used at a dose of 0.5 mg/kg, and in a single application IV has been short and requires monitoring in a hospital setting. IM use has been shown to be effective in treating depression and suicide risk, and have low side effect profile.MethodsTwo patients diagnosed with bipolar depression and suicide risk were submitted to ketamine IM application (0.75 mg/kg), receiving one application of ketamine IM every two days, totaling 4 applications. Patients were under medical monitoring for 2 hours after injection verifying vital signs and potential side effects. Responses were measured using BDI, BAI and BSI.AimTo evaluate response of ketamine IM injections on depressive, suicidal and anxious symptoms.SummaryCase 1: female, 20 years old, single with three recent suicide attempts, symptomatic for two months. Started lithium 450 mg daily. Side effects of ketamine were nausea, drowsiness and paresthesia. Case 2: female, 24 years old, single with symptoms lasting for six years. Started aripiprazole 5–10 mg and 25 mg lamotrigine concomitantly. Side effects of dry mouth, dizziness and dissociation.ConclusionsThe use of ketamine IM showed reduction of 75.5%–83.3%–85.7% (case 1) and 71.4%–77.2%–60.8% (case 2) in BDI, BAI and BSI, respectively as well as safety and tolerability in use.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionSeveral studies have shown that ketamine, an NMDA receptor antagonist, represents a promising alternative in treating depression and suicide. The intranasal or intravenous use of ketamine, currently used, has limitations in terms of cost and complexity. The subcutaneous (SC) route may be an affordable alternative for the treatment of depression and suicidality.ObjectivesTo evaluate the response of SC ketamine (0,5 mg/kg) applications on depressive, anxiety, and suicide symptoms.MethodsA patient with unipolar depression and suicide attempt was submitted to 3 sessions of SC ketamine (0,5 mg/kg). The applications had 2 days of intervals. Clinical evaluations were measured by BDI, BSI, and BAI. The vital signs were monitored under 2 hours after injections and the potential side effects.ResultsChanges in measurement instruments according to applications can be seen in Tab 1:BDIBSIBAIApplication 1261418Application 2030000Application 3020000The average measurements of vital signs during 2 hours of monitoring for each application can be seen in Tab 2:BPHRRFOXECGNine measurements (average)123/8078,8617,5599%NPConclusionsThe use of SC ketamine showed remission in BDI, BSI and BAI, respectively demonstrated safety in use.Disclosure of InterestNone Declared
IntroductionAccording to Article 5 of the Maria da Penha Law, domestic and family violence against women constitutes any action or omission based on gender that causes her death, injury, physical, sexual or psychological suffering, and moral or patrimonial damage, within the scope of the domestic unit, the family or any intimate relationship of affection. In isolation, domestic violence is already considered by the WHO a public health problem. In the context of a pandemic, as was the case with COVID-19, the issue had the severity increase.ObjectivesTo investigate the rates of domestic and family violence against women in the city of São João Batista, State of Santa Catarina, Brazil, between January 1, 2019, and December 31, 2020, relating the data to the COVID-19 pandemic.MethodsDescriptive cross-sectional study, operationalized by the technique of bibliographic and documentary research.ResultsThere was a reduction in the total number of crimes involving domestic and family violence against women in the city of São João Batista/SC, Brazil. While in 2019 there was a notification of 116 crimes, in 2020 the number dropped to 65. (Graph 1)The most frequent crimes in both years were: threat and bodily injury. Together they accounted for 83% of cases in 2020. (Graph 2)The apparent decrease in the number of notifications does not necessarily represent a decrease in cases of domestic violence, but rather, it may mean fear of leaving the residence to formalize the complaint, difficulty in carrying it out, or even the worsening of factors that increase the risk in these situations, such as reduction or total loss of income and support network.Image:Image 2:ConclusionsThe scenario presented shows the need for preventive public policies regarding the problem of domestic and family violence against women. The creation and strengthening of community and personal networks are fundamental.Disclosure of InterestNone Declared
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