Testes de rastreio para alterações psiquiátricas em esclerose múltipla – Revisão sistemática com metanálise

Silva, Maren de Moraes E; Mercer, Pilar Bueno Siqueira; Witt, Maria Carolina Zavagna; Pessoa, Renata Guedes Ramina; Viveiros, Camila Poletto; Gazola, Bruno Berardi; Oliveira, Diana Herchonvicz de; Ianisky, Rafaela

doi:10.1590/0047-2085000000213

Cited by 4 publications

(1 citation statement)

References 31 publications

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“…As manifestações neuropsíquicas acometem mais da metade dos portadores de EM [13][14] , enquanto os danos cognitivos prevalecem sobre 40 a 70% dos afetados. No entanto, a evolução para demência parece ser incomum [15][16][17][18] , enquanto a depressão vem sendo fortemente associada aos níveis de evolução da doença 19 . Apesar de possuir uma variedade enorme de apresentações clínicas, as manifestações referentes ao sistema nervoso autônomo são grande fonte de preocupação, pois levam a consequências importantes e prejuízo na qualidade de vida 20 .…”

Section: Introductionunclassified

Estudo epidemiológico sobre internações por esclerose múltipla no brasil comparando sexo, faixa etária e região entre janeiro de 2008 a junho de 2019 / Epidemiological study on multiple sclerosis hospitalization in brazil comparing sex, age and region between january 2008 to june 2019

Cassiano

Santos

Esteves

et al. 2020

BJHR

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Section: Introductionunclassified

Estudo epidemiológico sobre internações por esclerose múltipla no brasil comparando sexo, faixa etária e região entre janeiro de 2008 a junho de 2019 / Epidemiological study on multiple sclerosis hospitalization in brazil comparing sex, age and region between january 2008 to june 2019

Cassiano

Santos

Esteves

et al. 2020

BJHR

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Effectiveness of an internet-based self-guided program to treat depression in a sample of Brazilian users: a study protocol

Lopes

Meyer

Berger

et al. 2020

Braz. J. Psychiatry

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Although psychological treatments for depressive disorders are available, they are often expensive or inaccessible for many. Web-based interventions that require minimal or no contact with therapists have been shown effective. To the best of our knowledge, no study using this treatment format has been conducted in Brazil. The Deprexis program was designed using empirically established principles of cognitive-behavioral therapy to reduce depressive symptoms. The objective of this study was to evaluate the effectiveness of Deprexis in Brazil. This randomized controlled trial will include 128 Brazilians with clinically significant depression symptoms or who have been diagnosed with depressive disorder (major depressive disorder or dysthymia), recruited over the internet (Brazilian forums, social networks, or e-mail lists). Individuals with other psychiatric diagnoses that require significant attention (e.g., bipolar disorder, psychosis) will not be included in the trial. Participants will be randomly assigned to 1) treatment as usual plus immediate access to Deprexis or 2) treatment as usual plus delayed access to Deprexis (after 8 weeks). Participants will be able to obtain other treatment types in addition to the online intervention. If found effective, this web-based intervention would increase the evidence-based care options for depression treatment in Brazil.

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Effectiveness of an Internet-Based Self-Guided Program to Treat Depression in a Sample of Brazilian Users: Randomized Controlled Trial

Lopes¹,

Rocha²,

Svacina³

et al. 2023

JMIR Form Res

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Background Depression is undertreated in Brazil. Deprexis is a self-guided internet-based program used to treat depressive symptoms based on empirically supported integrative and cognitive behavioral therapy. Evidence from a meta-analysis supports Deprexis’ efficacy in German-speaking countries and the United States, but no study has been conducted using this program in countries with low literacy rates and large social disparities. Furthermore, few studies have investigated whether internet-based interventions ameliorate the psychological processes that might underlie depressive symptomatology, such as low perceived self-efficacy. Objective The main objective of this study was to replicate in Brazil previously reported effects of Deprexis on depressive symptom reduction. Therefore, the main research question was whether Deprexis is effective in reducing depressive symptoms and the general psychological state in Brazilian users with moderate and severe depression in comparison with a control group that does not receive access to Deprexis. A secondary research question was whether the use of Deprexis affects perceptions of self-efficacy. Methods We interviewed 312 participants recruited over the internet and randomized 189 participants with moderate to severe depression (according to the Patient Health Questionnaire–9 and a semistructured interview) to an intervention condition (treatment as usual plus immediate access to Deprexis for 90 days, n=94) or to a control condition (treatment as usual and delayed access to Deprexis, after 8 weeks, n=95). Results Participants from the immediate access group logged in at Deprexis an average of 14.81 (SD 12.16) times. The intention-to-treat analysis using a linear mixed model showed that participants who received Deprexis improved significantly more than participants assigned to the delayed access control group on the primary depression self-assessment measure (Patient Health Questionnaire–9; Cohen d=0.80; P<.001) and secondary outcomes, such as general psychological state measure (Clinical Outcome in Routine Evaluation–Outcome Measurement; Cohen d=0.82; P<.001) and the perceived self-efficacy measure (Cohen d=0.63; P<.001). The intention-to-treat analyses showed that 21% (20/94) of the participants achieved remission compared with 7% (7/95) in the control group (P<.001). The deterioration rates were lower in the immediate access control group. The dropout rate was high, but no differences in demographic and clinical variables were found. Participants reported a medium to high level of satisfaction with Deprexis. Conclusions These results replicate previous findings by showing that Deprexis can facilitate symptomatic improvement over 3 months in depressed samples of Brazilian users. From a public health perspective, this is important information to expand the reach of internet-based interventions for those who really need them, especially in countries with less access to mental health care. This extends previous research by showing significant effects on perceived self-efficacy. Trial Registration Registro Brasileiro de Ensaios Clíncos (ReBec) RBR-6kk3bx UTN U1111-1212-8998; https://ensaiosclinicos.gov.br/rg/RBR-6kk3bx/ International Registered Report Identifier (IRRID) RR2-10.1590/1516-4446-2019-0582

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Testes de rastreio para alterações psiquiátricas em esclerose múltipla – Revisão sistemática com metanálise

Cited by 4 publications

References 31 publications

Estudo epidemiológico sobre internações por esclerose múltipla no brasil comparando sexo, faixa etária e região entre janeiro de 2008 a junho de 2019 / Epidemiological study on multiple sclerosis hospitalization in brazil comparing sex, age and region between january 2008 to june 2019

Estudo epidemiológico sobre internações por esclerose múltipla no brasil comparando sexo, faixa etária e região entre janeiro de 2008 a junho de 2019 / Epidemiological study on multiple sclerosis hospitalization in brazil comparing sex, age and region between january 2008 to june 2019

Effectiveness of an internet-based self-guided program to treat depression in a sample of Brazilian users: a study protocol

Effectiveness of an Internet-Based Self-Guided Program to Treat Depression in a Sample of Brazilian Users: Randomized Controlled Trial

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