Adaptação transcultural do instrumento Refugee Health Screener - 15 para o português brasileiro

The forced migration process exposes the individual to different situations of vulnerability before, during and after arrival in the country of destination. In this context, the prevalence of anxiety, depression and post-traumatic stress disorder is double when compared to the non-refugee population. Brazil receives approximately 30,000 refugee requests annually, but it lacks mental health screening instruments adapted for this public. Thus, the objective of this research was to perform the translation and cross-cultural adaptation of the Refugee Health Screener - 15 (RHS-15) instrument from Spanish to Brazilian Portuguese. The aim was to create a bilingual instrument that would enable Brazilian professionals to assist Hispanic refugee populations in Brazil. This study involved the stages of translation and back-translation, evaluation by expert judges and the target audience. Statistical analysis was based on the assessment of agreement between translations and the measurement of the reliability of the results by the kappa coefficient. The RHS-15 was adapted to Brazilian Portuguese, giving rise to the Escala de Saúde para Refugiados - 15, which presents evidence of validity based on indicators of semantic and conceptual equivalence.

Letter to the editor. Healthcare workers on the edge of sanity due to COVID-19: Rapid review of the results of systematic reviews and meta-analyzes

This study assessed the prevalence, diagnosis, and treatment of major depressive disorder and generalized anxiety disorder among New York City adults. As part of the first community-specific Health and Nutrition Examination Survey in the United States, depression and anxiety were assessed in a representative sample of 1,817 noninstitutionalized adults in 2004. A total of 8% had major depressive disorder and 4% had generalized anxiety disorder. Respondents with depression were more likely to be formerly married, publicly insured, younger, and U.S. born. Only 55% of adults with depression were diagnosed, and 38% of those with depression or anxiety were in treatment; individuals with a diagnosis of depression were more likely to receive treatment than those without a diagnosis (61% versus 7%; p<.001). Immigrants with depression were 60% less likely to be diagnosed than their U.S.-born counterparts; immigrants arriving in this country ten or more years ago had slightly more anxiety than immigrants arriving less than ten years ago (3% versus 2%, not significant). Among respondents with anxiety, 23% reported disability compared with 15% of those with depression. Compared with adults with neither diagnosis, adults with depression or anxiety were twice as likely to smoke tobacco (p<.05), adults with depression were twice as likely to have diabetes (p<.01), and those with anxiety were twice as likely to have asthma (p<.01). Mental disorders are often disabling and inadequately diagnosed and treated. Foreign-born adults experience barriers to diagnosis and treatment despite having less depression; anxiety may increase with time since immigration. Increased awareness of and linkage to mental health services are needed, especially in larger, more diverse urban communities.

Comorbid anxiety and depressive disorders in people with epilepsy (PWE) are highly prevalent and associated with various adverse outcomes. However, the prevalence of anxiety disorders in PWE across studies is highly variable. Our aim was to estimate the prevalence and moderating factors of anxiety and depressive disorders in PWE. Following prospective registration (PROSPERO; CRD42015027101), electronic databases were searched for studies that reported the prevalence of both anxiety and depressive disorders in samples of PWE up until July 2016. Data extracted included the prevalence of anxiety and depressive disorders, and moderators of interest (e.g., method of diagnosis, prevalence of drug-resistant epilepsy). Meta-analysis of the overall pooled prevalence of anxiety and depressive disorders was conducted. The search yielded 8,636 unique articles, with 27 studies meeting final inclusion criteria (3,221 PWE). The pooled prevalence of anxiety and depressive disorders was 20.2% (95% confidence interval [CI] 15.3-26.0%) and 22.9% (95% CI 18.2-28.4%), respectively. Method of diagnosis significantly moderated anxiety disorder prevalence (Q statistic with one degree of freedom [Q1 ] = 36.29, p < 0.0001); the prevalence of anxiety disorders based on unstructured clinician assessment was 8.1% (95% CI 5.7-11.4%), compared to a prevalence of 27.3% (95% CI 22.1-33.3%) based on a structured clinical interview. There were no significant moderators of depressive disorder diagnosis. Findings suggest the prevalence of anxiety and depressive disorders in PWE are equivalent, and variability in prevalence of anxiety disorders across studies can be attributed partly to the method of diagnosis. These findings also challenge widely held assumptions that psychiatric comorbidity is more common in people with drug-resistant epilepsy. Future research should aim to improve the detection and management of these comorbidities in PWE, particularly anxiety disorders, which have remained relatively neglected.

Objective To measure the prevalence of maternal anxiety, depression and posttraumatic stress disorder (PTSD) in those exposed to natural disasters. Methods A literature search of the PubMed database and www.clinicaltrials.gov from January 1990 through June 2020 was conducted. A PRISMA review of the available literature regarding the incidence and prevalence of maternal anxiety, depression and posttraumatic stress disorder (PTSD) following natural disasters was performed. A natural disaster was defined as one of the following: pandemic, hurricane, earthquake and post-political conflict/displacement of people. Studies were selected that were population-based, prospective or retrospective. Case reports and case series were not used. The primary outcome was the prevalence of maternal anxiety, depression and PTSD in the post-disaster setting. Two independent extractors (I.F. & H.G.) assessed study quality using an adapted version of the Effective Public Health Practice Project Quality Assessment tool. Given the small number of studies that met inclusion criteria, all 22 studies were included, regardless of rating. Data were extracted and aggregate rates of depression, anxiety, and PTSD were calculated to provide synthesized rates of maternal mental health conditions among participants. Results Twenty-two studies met the inclusion criteria. A total of 8357 pregnant or birthing persons in the antepartum and postpartum periods were studied. The prevalence of post-pandemic anxiety, depression and PTSD were calculated to be 48.2%, 27.3%, and 22.9%. Post-earthquake depression and PTSD rates were 38.8% and 22.4%. The prevalence of post-hurricane anxiety, depression and PTSD were 17.4%, 22.5%, and 8.2%. The rates of post-political conflict anxiety, depression and PTSD were 48.8%, 31.6% and 18.5%. Conclusion Given the high rates of anxiety, depression and PTSD among pregnant and birthing persons living through the challenges of natural disasters, obstetrician-gynecologists must be able to recognize this group of patients, and provide a greater degree of psychosocial support.

The prevalence of anxiety, depression, and post-traumatic stress disorder among African migrants: A systematic review and meta-analysis

Background: Mental illnesses following an acute myocardial infarction (AMI) are a growing concern, as they are associated with worse outcomes for AMI patients. Our understanding of the prevalence of mental illnesses after an AMI is incomplete, as most studies investigate depression while overlooking other conditions like anxiety and PTSD. Existing studies often rely on patient-reported questionnaires for mental illness diagnoses, a method that can be subjective. To address this, we conducted a systematic review and meta-analysis to determine the prevalence and risk factors of depression, anxiety, and PTSD after AMI, including only studies with formal mental illness diagnoses. Methods: Searches in MEDLINE, EMBASE, and PsycINFO up to 23 January 2025 identified 23 qualifying studies that assessed the prevalence of depression, anxiety, and PTSD after AMI, with cases defined exclusively by formal diagnoses established through psychiatrist-administered structured interviews according to the Diagnostic and Statistical Manual for Mental Disorders (DSM) criteria (versions III to V). For each outcome, the pooled prevalence was estimated using meta-analyses of proportions with random-effects models. If significant heterogeneity was detected, subgroup analyses and meta-regression were performed to explore the factors contributing to this heterogeneity. Results: A total of 25 studies were included in the meta-analysis. Among the 20 studies included, the pooled prevalence of depression after AMI was 23.58% (95% CI: 22.86%; 24.32%). When stratified by time since AMI, the prevalence was 19.46% (95% CI: 15.47%; 24.19%) for those assessed within 3 months and 14.87% (95% CI: 9.55%; 22.43%) for those assessed after 3 months. The pooled prevalence of anxiety (seven studies) and PTSD (three studies) was 11.96% (95% CI: 6.15; 21.96%) and 10.26% (95% CI: 5.49%; 18.36%), respectively. Further pooled prevalence subgroup analysis of depression and anxiety revealed significantly higher rates in the female sex (29.89%, 95% CI: 21.85; 39.41%), in those with hypertension (25.01%, 95% CI: 21.68; 28.67%), diabetes (25.01%, 95% CI: 21.68; 28.67%), or hyperlipidemia (28.96% 95% CI: 23.44; 35.17%), and in smokers (25.23%., 95% CI: 19.48; 32.00%), while the pooled prevalence of depression is higher in unmarried (35.44%, 95% CI: 19.61; 55.26%) than married individuals (28.63%, 95% CI: 18.67; 41.20%) and in those with a history of depression (57.41%, 95% CI: 31.47; 78.92%). The results of the meta-regression indicated that a prior history of depression was a significant predictor of depression prevalence (p = 0.0035, regression coefficient 1.54). Conclusions: The prevalence of mental illnesses, including depression, anxiety, and PTSD, is notable following an AMI. Identified risk factors encompass female sex, hypertension, diabetes mellitus, hyperlipidemia, smoking, a history of depressive illness, and social context.

Background: Amputees have been noted to present various psychiatric disorders including anxiety, body image disturbances, depression, and Post-Traumatic Stress Disorder (PTSD). However, there is limited data available on the prevalence of anxiety, depression, and PTSD among amputees in Kenya despite the high incidences of amputations in Kenyan hospitals. This study aimed at finding out the prevalence of anxiety, depression, and post-traumatic stress disorder among amputees attending the Jaipur Foot Trust Centre in Kenya. Method: This study took a cross-sectional descriptive study design. One hundred and forty-one patients attending the Jaipur Foot Trust were recruited to participate in the study after giving informed consent using a non-probability purposive sampling method. A socio-demographic questionnaire was used to collect socio-demographic characteristics. The Patient Health Questionnaire (PHQ-9) was used to assess the patient's depression. The Generalized Anxiety Disorder (GAD-7) scale was used to assess the patient's anxiety level and The Impact of Event Scale (IES-R) was used to assess the severity of post-traumatic stress disorder (PTSD). Data analysis was done using Statistical Package for Social Science (SPSS) version 23. Results: Findings from this study showed high rates of psychiatric morbidity where two-thirds of the patients reported PTSD (65%) with more than three-quarters of patients being diagnosed with depression (89.4%) and anxiety (91.5%). Also, there was a significant correlation between depression, anxiety, and PTSD, such that participants who had higher scores on anxiety and depression had significantly higher PTSD scores. Conclusion: Anxiety, Depression, and PTSD are very common psychological reactions in patients who have undergone amputation. The researchers expected that some of the sociodemographic factors and some amputation-related characteristics would have a relation with psychiatric comorbidity. However, the findings of this study did not show any such relationship except the relation between anxiety, depression, and PTSD. Early psychological assessment and interventions after amputations will help alleviate psychological distress.

BackgroundThere is limited data available on the long-term mental health impact of Ebola virus disease (EVD) on survivors despite the disease experience of survivors meeting the criteria of a traumatic event as defined in the Diagnostic and Statistical Manual of Mental Disorders version IV (DSM IV). This study aimed to assess the prevalence and predictive factors of anxiety, depression and posttraumatic stress disorder among EVD survivors, approximately 2 years after discharge from the Ebola treatment centre (ETC).MethodsWe conducted a cross-sectional study between May and August 2017 among 197 adults Ebola survivors in Bombali district, Northern Sierra Leone. We collected information about demographics, mental health status and possible predictive factors. The HAD scale was used to measure anxiety and depression. PTSD was measured using the PTSD-checklist (PCL). Chi-square test or Fisher exact two-tailed tests were used to test for associations and the multiple logistic regressions model to determine factors that were independently associated with the outcome variables.ResultsThe mean anxiety, depression and PTSD scores were (5.0 ± 3.9), (7.1 ± 3.8) and (39.5 ± 6.4) respectively. Based on cut-off scores, the prevalence of anxiety (HADs score ≥ 8), depression (HADs score ≥ 8) and PTSD (PCL ≥ 45) among Ebola survivors were (n = 49, 24.9%), (n = 93, 47.2%) and (n = 43, 21.8%) respectively. Older Ebola survivors (≥30 years) were more likely to show symptoms of depression (AOR = 8.5, 95% CI: 2.68–27.01, p = 0.001) and anxiety (AOR = 3.04; 95%CI: 1.2–7.7, p = 0.019) compared to younger ones (< 30 years). In addition, Ebola survivors who experienced a decreased level of exercise post-ETC discharge were more likely to show symptoms of depression (AOR = 2.63; 95%CI: 1.25–5.54, p = 0.011) and anxiety (AOR = 3.60; 95%CI: 1.33–9.72, p = 0.012) compared to those whose exercise remained the same post-ETC discharge.ConclusionOur findings show that anxiety, depression and PTSD are common among the Ebola survivors in Bombali district, Northern Sierra Leone, and that underscores the need to diagnose and manage mental health morbidities among Ebola survivors long after their recovery from Ebola virus disease. Cognitive Behaviour Therapy (CBT) and Interpersonal Therapy (IPT) need to be explored as part of overall mental healthcare package interventions.

Introduction: Depression and anxiety disorders are much more common among medical students than in the general population. Due to additional risk factors, foreign students may be particularly vulnerable. Despite this, there is still an insufficient number of studies analyzing the prevalence of mental disorders among foreign medical students, especially in Poland. Aim: The aim of the study was to assess and compare the prevalence of anxiety and depression disorders between domestic and foreign medical students in Poland. Material and methods: An anonymous internet survey containing questions about socio-demography and the Hospital Anxiety and Depression Scale questionnaire was distributed among students. Based on the field of study and country of origin, participants were divided into 3 groups – Polish medical student group (PMG, n = 214); foreign medical student group (FMG, n = 59) and control group, which were Polish students of other faculties (CG, n = 476). The study groups were compared using the χ2 test. Results and discussion: The prevalence of depression disorders was 30%, 31% and 28% (PMG, FMG and CG, respectively). No statistically significant difference was observed between the study groups (P = 0.77). The prevalence of anxiety disorders was 57%, 90% and 59% (PMG, FMG and CG, respectively). Anxiety disorders were more common among FMG as compared to PMG and CG (P &lt; 0.01 in both cases). Conclusions: The prevalence of depression and anxiety among medical students in Poland is high. Foreign medical students appear to be particularly vulnerable to anxiety disorders.

Patients with inflammatory bowel disease (IBD) are more susceptible to mental health problems than the general population; however, temporal trends in psychiatric diagnoses' incidence or prevalence in the United States are lacking. We sought to identify these trends among patients with IBD using national Veterans Heath Administration data. We ascertained the presence of anxiety, depression, or posttraumatic stress disorder among veterans with IBD (ulcerative colitis or Crohn's disease) during fiscal years 2000-2015. Patients with prior anxiety, depression, or posttraumatic stress disorder before their first Veterans Health Administration IBD encounter were excluded to form the study cohort. We calculated annual prevalence, incidence rates, and age standardized and stratified by gender using a direct standardization method. We identified 60,086 IBD patients (93.9% male). The prevalence of anxiety, depression, and/or posttraumatic stress disorder increased from 10.8 per 100 with IBD in 2001 to 38 per 100 with IBD in 2015; 19,595 (32.6%) patients had a new anxiety, depression, and/or posttraumatic stress disorder diagnosis during the study period. The annual incidence rates of these mental health problems went from 6.1 per 100 with IBD in 2001 to 3.6 per 100 in 2015. This trend was largely driven by decline in depression. The prevalence of anxiety, depression, and posttraumatic stress disorder is high among US veterans with IBD and increasing, given the chronicity of IBD and psychological diagnoses. Incidence, particularly depression, appears to be declining. Confirmation and reasons for this encouraging trend are needed.

ObjectivesTo assess the prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) and their associated factors among the caregivers of children diagnosed with cancer in Oman and explore the changes...

Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore.

ABSTRACTObjectiveAdolescents and young adults (AYA) with HIV are a population at high risk of experiencing mental issues and sleep disorder. We aim to summarise the global prevalence and risks of depression, anxiety, post-traumatic stress disorder (PTSD) and sleep disorder among AYA with HIV.DesignSystematic review and meta-analysis.Data sourcesPubMed, Web of Science, Embase and PsycINFO were searched from inception to 3 August 2024.Eligibility criteriaObservational studies reporting the prevalence of depression, anxiety, PTSD or sleep disorder among AYA with HIV and published in English were included. Reviews, case reports, conference papers, notes, editorials and non-observational research were excluded.Data extraction and synthesisTitles, abstracts and full texts were reviewed and screened, and data were independently extracted. A modified Newcastle-Ottawa Quality Assessment Scale (NOS) was used to evaluate study quality. Heterogeneity was assessed by I2 statistics, and subgroup analysis was performed to identify the source of heterogeneity. The pooled prevalence and the risks of depression, anxiety, PTSD and sleep disorder by comparison with HIV-uninfected peers were measured with random-effects and fixed-effects models. Publication bias was examined using Egger’s correlation tests and funnel plot. The Grading of Recommendations Assessment, Development and Evaluation was used to assess the certainty of evidence.Results56 articles were included in the final analysis. According to the modified NOS, 13 (23.2%) studies were considered good, 38 (67.9%) were satisfactory and 5 (8.9%) were unsatisfactory. 51 studies including 21 735 AYA with HIV contributed data for the pooled prevalence of depression (28%, 95% CI 24% to 32%, I2=98.68%; low certainty evidence); 21 studies including 8021 cases contributed data for the pooled prevalence of anxiety (22%, 95% CI 17% to 27%, I2=98.35%; low certainty evidence); 9 studies including 3691 cases contributed data for the pooled prevalence of PTSD (12%, 95% CI 8% to 17%, I2=95.60%; low certainty evidence); and 4 studies including 1909 cases contributed data for the pooled prevalence of sleep disorder (51%, 95% CI 31% to 70%, I2=98.37%; low certainty evidence). Compared with AYA without HIV, those with HIV had a higher risk of depression (OR=2.67, 95% CI 1.63 to 5.90, I2=84.0%), anxiety (OR=1.89, 95% CI 1.32 to 2.69, I2=50.3%), PTSD (OR=1.58, 95% CI 1.23 to 2.04, I2=40.1%) and sleep disorder (OR=2.11, 95% CI 1.51 to 2.95, I2=0.0%). A subgroup analysis found that studies conducted in Asia had a lower prevalence of depression (21.7% vs 29.6%, p<0.001) and anxiety (14.7% vs 21.9%, p<0.001) than studies conducted in Africa. Egger’s test indicated that there was significant publication bias in the estimates of the prevalence of depression (p<0.001), anxiety (p<0.001) and PTSD (p=0.049), but not in the estimates of the prevalence of sleep disorder (p=0.861).ConclusionsAYA with HIV are a population at high risk of experiencing depression, anxiety, PTSD and sleep disorder. More sensitive screening strategies and more comprehensive intervention methods are needed. However, in view of the high heterogeneity, the differences between studies need to be considered and the pooled estimates interpreted with caution.

ObjectiveThe COVID-19 pandemic has placed health care workers under psychological stress. Previous reviews show a high prevalence of mental disorders among health care workers, but these need updating and inclusion of studies written in Chinese. The aim of this systematic review and meta-analysis was to provide updated prevalence estimates for depression, anxiety and post-traumatic stress disorder (PTSD) among health care workers during the COVID-19 pandemic, benefitting from the inclusion of studies published in Chinese.MethodsSystematic search of EMBASE, MEDLINE, PsycINFO, Global Health, Web of Science, CINAHL, Google Scholar and the Chinese databases SinoMed, WanfangMed, CNKI and CQVIP, for studies conducted between December 2019 and August 2020 on the prevalence of depression, anxiety and PTSD in health care workers during the COVID-19 pandemic. Studies published in both English and Chinese were included.ResultsData on the prevalence of moderate depression, anxiety and PTSD was pooled across 65 studies involving 97,333 health care workers across 21 countries. The pooled prevalence of depression was 21.7% (95% CI, 18.3%-25.2%), of anxiety 22.1% (95% CI, 18.2%-26.3%), and of PTSD 21.5% (95% CI, 10.5%-34.9%). Prevalence estimates are also provided for a mild classification of each disorder. Pooled prevalence estimates of depression and anxiety were highest in studies conducted in the Middle-East (34.6%; 28.9%). Subgroup and meta-regression analyses were conducted across covariates, including sampling method and outcome measure.ConclusionsThis systematic review and meta-analysis has identified a high prevalence of moderate depression, anxiety and PTSD among health care workers during the COVID-19 pandemic. Appropriate support is urgently needed. The response would benefit from additional research on which interventions are effective at mitigating these risks.