Nowadays, major depression in children and adolescents is understood to be a common, disabling and recurrent disease, with a high level of morbidity and mortality. It is an important public health problem.
OBJECTIVES: To assess, using the self-report questionnaire Children's Depression Inventory (CDI), the rate of depressive symptoms and its distribution by age and gender, in a sample of students. METHODS: Application of the CDI in 463 students, aged 10 to 17. RESULTS: The total mean score was 13.0 with a standard deviation of 7.0 (median = 12.0), for females the score was 14.4 with a standard deviation of 7.2 (median = 13.0) and for males it was 11.1 with a standard deviation of 6.2 (median = 10.0). Using the cut-off score of 19, 20.3% of the students had important indications of depressive symptoms. The age factor had no significance; however, there was a non-significant trend of increasing rates of depressive symptoms in the ages of 10 to 15 and a decreasing trend in the ages of 16 to 17. There was a statistically significant predominance of females above the cut-off score compared to males (72.3% versus 27.7%), with a ratio of 2.6 females for each male. CONCLUSIONS: These results suggest that adolescent students have a high level of depressive symptoms, with a clear predominance of females over males, and a probable period of onset concentrated between the ages of 12 and 15 years.
ResumoAtualmente, a depressão em adolescentes é considerada comum, debilitante e recorrente, envolvendo um alto grau de morbidade e mortalidade, representando um sério problema de saúde pública, mesmo sendo bastante recente o interesse científico pela depressão neste período da vida. Os sistemas diagnósticos atuais definem que os sintomas básicos de um episódio depressivo maior são os mesmos em adolescentes e adultos, entretanto, os pesquisadores destacam a importância do processo de maturação na apresentação sintomatológica da depressão, com características predominantes em cada fase do desenvolvimento. Este artigo visa apresentar uma revisão sobre as características clínicas da depressão na adolescência com o objetivo de contribuir com o esclarecimento desta patologia grave, comum e ainda pouco reconhecida. Palavras-chave: depressão; adolescência; características clínicas. Abstract Depression in adolescence: clinical featuresNowadays, depression in adolescents is understood to be a common, disabling and recurrent disease, with a high level of morbidity and mortality. Thus, it is an important public health problem. Nevertheless, the scientific concern with depression in adolescence is recent. The present diagnostic systems define that the basic features are the same in adolescents and adults in a major depression episode; however, researchers emphasize the importance of the developmental process in the clinical manifestations, with predominant features in each phase. This paper reviews the clinical features in depressed adolescents contributing to a better understanding of this common, severe and not very well recognized pathology. Keywords: depression; adolescence; clinical features.Os transtornos depressivos apresentam alta e crescente prevalência na população geral (Bahls, 1999), e existem evidências científicas suficientes situando as depressões entre as doenças mais comuns, prejudiciais e que causam mais custos sociais, representando um problema dos mais graves em saúde pública, com impacto em todos os níveis da sociedade (Judd, 1995). A Organização Mundial de Saúde indica que nas próximas duas décadas haverá uma mudança nas necessidades de saúde da população mundial devido ao fato de que doenças como a depressão estão, rapidamente, substituindo os tradicionais problemas das doenças infecciosas e de má nutrição. O prejuízo causado pelas doenças, medido pela Disability Adjusted Life Years, mostra que a depressão maior, quarta causa geradora de sobrecarga em 1990, será a segunda causa no ano 2020, só perdendo para doenças cardíacas isquêmicas (Bahls, 1999;Murray & Lopez, 1996). Especialmente se considerarmos que o curso clínico da depressão maior costuma ser marcado por recorrências e cronicidade (Hirschfeld, 1998), podemos estabelecer uma noção clara da importância e gravidade desta patologia na população geral.Entretanto, o interesse científico pela depressão em adolescentes é bastante recente, pois, até a década de 70, acreditava-se que a depressão nessa faixa etária fosse rara
Neither fluoxetine nor sertraline was associated with clinically significant changes in thyroid function or thyroid autoimmunity in either primary hypothyroid or normal thyroid function patients with depression. However, results suggest that patients with normal thyroid function who were treated with fluoxetine are more susceptible to minor changes within the serotoninergic system than patients with hypothyroidism on the same SSRI therapy. To the best of our knowledge, this is the first study to demonstrate the safety of administering SSRIs in hypothyroid patients.
After many years of research, the precise relationship between the HPT axis and depressive disorders remains obscure, and the mechanism underlying the thyroid abnormalities in depressive patients remains indeterminate. Thus, considerable further investigation will be necessary to understand the role of the HPT axis in the pathogenesis and treatment of depressive disorders.
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