PSIQ - Artigos publicados em revistas não indexadas
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- Aspectos psicológicos do doente oncológicoPublication . Cardoso, G; Luengo, A; Trancas, B; Vieira, C; Reis, DA doença oncológica é acompanhada de marcado sofrimento psicológico que atinge o doente e a família. O doente enfrenta, a partir do momento do diagnóstico, um conjunto de mecanismos e de tarefas de adaptação à doença e suas circunstâncias. A grande prevalência de quadros de ansiedade e depressão no seu decurso é mais acentuada na fase terminal. Destes factos decorre a necessidade de um plano terapêutico global integrando os cuidados somáticos e psicológicos/psiquiátricos em todos os estadios da doença oncológica. Os profissionais de saúde também estão sujeitos a reacções emocionais face ao sofrimento que presenciam, pelo que, é importante estarem atentos aos aspectos emocionais e desenvolverem formação que lhes permita intervir de forma adequada junto do doente e da família. A articulação de oncologistas e profissionais de cuidados paliativos com as equipas de saúde mental pode ter um papel importante para a prestação de cuidados de qualidade a doentes oncológicos.
- A brief diagnostic screening instrument for mental disturbances in general medical wardsPublication . Fink, P; Ørnbøl, E; Huyse, F; Jonge, P; Lobo, A; Herzog, T; Slaets, J; Arolt, V; Cardoso, G; Rigatelli, M; Hansen, MOBJECTIVE: Mental illness is prevalent among general hospital ward patients but often goes unrecognised. The aim of this study was to validate the SCL-8d as a brief questionnaire for mental disturbances for use in general hospitals. METHODS: The study included 2040 patients, 18 years or older, consecutively admitted to 11 general internal medicine wards in seven European countries. All patients were screened on admission by means of the SCL-8d questionnaire. The psychometric performance (i.e., the internal validity) of the SCL-8d scale was tested using modern item response theory (IRT) in the form of the Rasch model. RESULTS: Differences between sample characteristics were considerable. Even so, the SCL-8d scale showed a remarkable, statistically significant fit in terms of internal homogeneity (P>.01) in all individual settings, except in Spain and Germany where the item "Everything is an effort" had to be excluded to obtain a fit. When pooling data from all centres, an excellent statistical significance of fit (P>.05) was obtained by exclusion of the "Effort" item. The scale was homogeneous as to gender (P>.05), but not age as it performed better among young patients than among patients older than 60 years (P<.01). In these two patient groups both internal and external homogeneity (gender, median age) was achieved. The SCL-8d sum score showed a marked correlation with current and previous treatment for mental illness. CONCLUSION: Apart from the "Effort" item ranking differently on the latent severity dimension as to age, the SCL-8d seems very robust from a psychometric point of view. Besides being short, the SCL-8d scale contains only emotional symptoms. It would therefore seem to be an excellent diagnostic tool for use in medical settings.
- Current and lifetime psychiatric illness in women with Turner syndromePublication . Cardoso, G; Daly, R; Haq, N; Hanton, L; Rubinow, D; Bondy, C; Schmidt, PAbnormalities in quality of life and cognitive measures have been observed in women with Turner syndrome (TS), and a relationship between these phenomena and chromosomal constitution has been suggested. In contrast, few studies have systematically evaluated the presence of mood and behavioral syndromes in these women. In this study, 100 TS women were administered the Structured Clinical Interview for DSM IV after a two-week period during which their hormone replacement had been discontinued. The majority of women who met criteria for a psychiatric condition had a mood or anxiety disorder. Overall, 52 (52%) of the TS women met criteria for a current or a past depressive or anxiety disorder. Eighteen of the women with TS met criteria for a current Axis I psychiatric disorder [Depression--major (n = 5), minor (n = 5), dysthymia (n = 1); Anxiety (n = 9)]. Forty-six of the women with TS met criteria for a past Axis I psychiatric illness [Depression: unipolar (n = 41), bipolar (n = 3); Anxiety (n= 7); eating disorder (n =6); substance dependence (n = 3)]. Five women with TS met criteria for an Axis II personality disorder. Women with TS reported a higher rate of lifetime depression compared with rates observed in community-based studies but similar to those obtained from gynecologic clinic samples.
- Depression, Anxiety and Alcohol Abuse in a Gastroenterology Intensive Care Unit: Prevalence and DetectionPublication . Cardoso, G; Alexandre, J; Rosa, AObjectives: To assess depression, anxiety, and alcohol abuse in a Gastroenterology ICU, and the level of its detection by the staff. Method: All patients consecutively admitted to the ICU during a six-month period, 18 or above, and staying 24 hours, were assessed with the Hospital Anxiety and Depression Scale (HADS) and the CAGE. Doctors and nurses assessed the type and severity of patients’ morbidity. Data were analyzed with Student’s t-test, Pearson’s and Spearman’s correlations for ordinal variables, chi-square for nominal variables, and multiple logistic regression. Results: The 65 patients assessed had a mean age of 57, and were predominantly male (58.5%), married (72.3%), and retired (53.8%); 27.7% had a psychiatric history, 24.6% were on psychotropic drugs, and 32.3% had an alcohol intake above standards. Anxiety and depression HADS scores 8 were present in 29.2% and 35.4% of the patients, respectively; 20%, mainly men, scored positive on the CAGE. Women had significantly higher anxiety scores (=.012) than men but did not differ in depression. A psychiatric history was significantly associated with higher anxiety (p<.001) and depression (p=.007) scores, as well as being on psychotropic drugs regularly (p<.001; p=.03, respectively). Doctors diagnosed somatic illness in 48.8%, and somatic illness with psychiatric co-morbidity in 51%; for nurses the rates were, respectively, 41.5% and 58.6%. Doctors’ and nurses’ detection of psychiatric disorders were significantly associated with the HADS anxiety scores (p=.013; p=.001, respectively), and doctor’s detection with depression (p=.046) scores. There were no significant associations between nurses’ detection of psychiatric disorders and depression, and between both professional groups detection and alcohol abuse. Conclusion: High prevalence of depression, anxiety, and alcohol abuse in Gastroenterology ICU was confirmed. However, the level of detection by the staff was low and mainly when anxiety symptoms were present.
- Mental disturbances and perceived complexity of nursing care in medical inpatients: results from a European studyPublication . Jonge, P; Zomerdijk, M; Huyse, F; Fink, P; Herzog, T; Lobo, A; Slaetz, J; Harolt, V; Balogh, N; Cardoso, G; Rigatelli, MAIMS AND OBJECTIVES: The relationship between mental disturbances - anxiety and depression, somatization and alcohol abuse - on admission to internal medicine units and perceived complexity of care as indicated by the nurse at discharge was studied. The goal was to study the utility of short screeners for mental disturbances to select patients for case-management on admission. DESIGN: The study had a cohort design: patients were included on admission and followed through their hospital stay until discharge. The study was conducted within the framework of the European Biomed 1 Risk Factor study. RESEARCH METHODS AND INSTRUMENTS: In the first 3 days of admission the patients were interviewed by a trained health care professional, who scored the SCL-8D, a somatization questionnaire based on the Whiteley-7 and the CAGE. At discharge, nurses rated the complexity of the patient's care. RESULTS: Patients with high scores on anxiety and depression (SCL-8D) and on somatization received higher ratings on perceived nursing complexity than those with low scores, with and without control for age, severity of illness and chronicity. The actual nursing intensity and medical care utilization, as measured daily by means of a checklist, could not explain these relations. No differences were found between patients with high or low scores on alcohol abuse. CONCLUSIONS: The study shows a potential use of screeners for mental disturbances to detect patients for whom nurses might need additional help. However, mental disturbance is not the sole criterion: functional status and other variables that predict medical and nursing care utilization should be included in a screening strategy for case-management programmes
- Perturbações psiquiátricas no Hospital GeralPublication . Cardoso, GUma extensa revisão da literatura mostra que as perturbações psiquiátricas são muito prevalentes nos serviços não psiquiátricos e nas consultas externas do hospital geral, atingindo taxas muito superiores às encontradas na população geral. As perturbações depressivas são as mais prevalentes, seguidas das ansiosas e das cognitivas, mas a sua distribuição difere entre serviços e populações estudadas. Tais factos permitem concluir que é mandatória a criação de equipas de Psiquiatria de Ligação que possam, não apenas diagnosticar e tratar as situações psicopatológicas, mas também aumentar a capacidade da sua detecção e tratamento pelas equipas médicas.
- Shyness, social anxiety, and impaired self-esteem in Turner syndrome and premature ovarian failurePublication . Schmidt, P; Cardoso, G; Ross, J; Haq, N; Rubinow, D; Bondy, C