Avaliação da prevalência de depressão no paciente com

(1)

TO O

Ava a !ã " #a p $%va &' ( a # % #%p $%)) ã " ' " pa ( %'t% ("o

ŚŝƉŽƟƌĞŽŝĚŝƐŵŽ

ƐƐĞƐƐŵĞŶƚ ŽĨ ƚŚĞ ƉƌĞǀĂůĞŶĐĞ ŽĨ ĚĞƉƌĞƐƐŝŽŶ ŝŶ ƚŚĞ ƉĂƟĞŶƚ ǁŝƚŚ

hy* +,hy-+ .0 .1 3

G 456 7879 :;:<= 7J> <? 8>C755 ?@ B>D49 55 :D 7 E

FC76 ?@ 7 H4 8IK ?>D4S> :L 7C75M 7@ B> N

FP 75 K4@ >Q> KB7U 7< <45 V?< <7

W F

XYZ [\] ^ _`[b] c \ `bf bg\ ij ^k l bc j ^f m n ^k qm^c r k sc^i\f u wxc ^ [z ^`[^ m { Ym [\]\`^ |mf ^} `\~mc i\ [^[mlm[m c ^f [b q m ^cr} lq k l bc j ^f m n^ kqm^c r ksc^i\f uYm ijcmm{_`[] b]c\`bf bg \ ^mYZ [\]bqbf ^bc ^ [bc[bm c~ \ b[m_`[b] c \ `bf bg \ ^m \ ^m jm i[b bi|\ j ^f } `\~mci\ j rc\b^f jmcq^`j[\ b}q klbc j ^fmn^kq m ^c r ks c ^ i\f u

\ ijc \ bi [bi bc{`\ bi j \c m b\ [m ^`bi r {z \ j bi ^`bi ib ^iib]\^ [bi à[m |cmiibk `b m `j ^`j bk^ `^ jzc m n^ [m ii^ cm f ^bjm {

VLGR GLItFLO GH GH¿QLU Mi TXH RV HVWXGRV DFHUFD GR WHPD PRVWUDP UHVXOWDGRV FRQÀLWDQWHV 2EMHWLYRXVH DYDOLDU DWUDYpV GH

HVWXGRWUDQVYHUVDODQDOtWLFRDSUHVHQoDGHGHSUHVVmRHPSDFLHQWHVFRPKLSRWLUHRLGLVPRSULPiULRWUDWDGRVDGHTXDGDPHQWHFRP

f m~ bj \c b\ `^k ] b{ |^c ^ [bi ] b{] b`jc bf m i ] b{z `bj \cm b\ [m `^`bc { ^f u ^c ^^~ ^f \ ^b[^|c m im `^ [m[m |cmiibb\z i^[b b `~m`jrc \ b[mm|cm iib[ms m] s u^c j \] \ |^c^{[bm ijz [b|^]\m`jm iu|b`jz ^b`bsjm ~m{Z[\ ^[mX kX±X kw`b gcz |b\ |bj \cm b\ [\ i{ bm[m k± kwk`bgcz |b]b`jcbfm | k u¡bbz~mcmf ^bm`jc m`~m \ iiZc \]bi{ ^ \bc m i[m¢m

SRQWXDomRPDLVDOWDQR,'%1mRIRLHQFRQWUDGDGLIHUHQoDVLJQL¿FDWLYDHQWUHRVJUXSRVVXJHULQGRQmRKDYHUFRUUHODomRHQWUHR

KLSRWLUHRLGLVPRWUDWDGRDGHTXDGDPHQWHHGHSUHVVmRDSHVDUGHWHUVLGRREVHUYDGDXPDWHQGrQFLDDXPULVFRPDLRUGHGHSUHVVmR

QRJUXSRKLSRWLUHRLGLVPR&RQVLGHUDQGRRQ~PHUROLPLWDGRGDDPRVWUDHRVGDGRVFRQÀLWDQWHVVmRQHFHVViULRVPDLVHVWXGRVFRP

SRSXODomRPDLVQXPHURVDSDUDFRQ¿UPDURXQmRHVVHVDFKDGRV

£ ¤¥ ¤¦§ ¤¨© ª« ¤¦ ¬ \ |bj\cmb\ [\i{ bum |c m iibu bc {`\ bij \cm b\ [m ^ `biu

®¯°®²°

\ ibc [mcibjmj³c b\ [bc { b`mi^~mf b`gmm`^ iib]\^ jm [´\ j[m |c m ii\b`kb´m~m ckjm`^ jzcmbj\icm f ^ j\ b`i\ |^ im m `

GLI¿FXOWWRGH¿QHVLQFHVWXGLHVRQWKHVXEMHFWVKRZFRQÀLFWLQJUHVXOWV7KHREMHFWLYHZDVWRHYDOXDWHWKURXJKDQDO\WLFDOFURVV

im]j\ b`^fijz [³kjm|cmim `]mb[m|cm ii\ b`\ `|^j \m `j i´\ j|c\{ ^c³³|bj³c b\ [\ i{|c b|m cf³jcm^jm [´\ jf m~ bj³c b\ `m] b{ |^cm[ ´\ j] b`jc bf i´\ j`bc{ ^fj³c b\ [z `] j \ bù¢bm~ ^f z ^jmjm|cmim `]mb[m |c m ii\ b`´îz im [s m ] m |c m ii\ b` `~m `j bc³ su ¢mijz [³\ `]f z [m [|^j \m `j iu¢mi] bc mb`jms ^~m c ^gm[X uX±X uw\ `jm³|bj³c b\ [\i{gcbz |^`[ u± uw\`jm ] b`jc bfgc bz | | u u¢m cm´^ i`bcmf ^ j\ bì\ |mj´mm `\gmcimcz{f m~mf ib¢^ `[\gmci] bc m ib`jms u¢mcm´î

QRVLJQL¿FDQWGLIIHUHQFHEHWZHHQWKHJURXSVVXJJHVWLQJQRFRUUHODWLRQEHWZHHQK\SRWK\URLGLVPWUHDWHGSURSHUO\DQGGHSUHVVLRQ

^f jbzg\j´îbimc ~m [^jm `[m `]³j b^`\ `]cmîm [c \ ib[m |c m ii\b`\ `³|bj³cb\[\ i{gcbz |uq bì\ [mc \ `gjmf \{ \ jm [i^{ |fm

VL]HDQGWKHFRQÀLFWLQJGDWDPRUHVWXGLHVDUHQHHGHGZLWKODUJHUSRSXODWLRQWRFRQ¿UPRUQRWWKHVH¿QGLQJV

µ ¬¶·¸§ ¹ ¨³|bj³c b\ [\ i{ um |cmii\ b`u¢³cb\[bc { b`miu

º »¼ ½¾¿ ½¾ ¾ ÀÁ Â½ÃÄÀ Ã¼À ÅÆ eÇÈÉ ÉÊËÌ ËÍ ÎÉÏ dÍ dÉ ÇÇ ÐÑ d eÊ Ç Ç ËÉ ÒR ËÉÓ Ð ÉÏÉ ÎÉÑÔÒ ÒÉ Î d Ò e ÇeÐeÍ Òd ÇÎÉ ÐeÕÉ ÒeÉ ÇÖ ×Ø 2 ÙeÐeÚdeÛ ×ÈÉ ÐÌ eÇÈÉ ÉÉ ËÌ ËÍÎÉ Ü ÔÉÑddÝdÈÞ Ç

&RQÀLWRGHLQWHUHVVHV

1mRKiTXDOTXHUFRQÀLWRGHLQWHUHVVHVSRUSDUWHGHTXDOTXHUXPGRVDXWRUHV

(2)

I O O

D pr m réu md g r i p i a a a md

SHOD2UJDQL]DomR0XQGLDOGH6D~GHGHWRUQDUVHDVHJXQGD

m m pra a i u d ipid d p rd d d a rb m

1

U m i a r pa rd md pr a m d ia p d m m d i pr mu a p r d

QDWXUH]D GHVVD UHODomR H R TXH D GHWHUPLQD QmR WHUHP VLGR

FRQYLQFHQWHPHQWH SURYDGDV 2EVHUYDo}HV DFHUFD GH RQGH

d r a i s m r d d d a m a r pi a r m a d pr m d i m pa rd m

R XVR WHUDSrXWLFR GH KRUP{QLRV WLUHRLGHDQRV QR PDQHMR GD

GHSUHVVmRHDVDSDUHQWHVDQRUPDOLGDGHVQRHL[RKLSRWiODPR

KLSy¿VHWLUHyLGHGHLQGLYtGXRVFRPGHSUHVVmR

2

1R%UDVLOSRXFRVHVWXGRVSRSXODFLRQDLVWrPVLGRIHLWRVFRPD

¿QDOLGDGHGHLQYHVWLJDUDRFRUUrQFLDGHGHSUHVVmRHPSDFLHQWHV

FRP GLVIXQo}HV WLUHRLGLDQDV FRPR KLSRWLUHRLGLVPR 7HQGR

HP YLVWD DV GLYHUVDV HYLGrQFLDV HP HVWXGRV LQWHUQDFLRQDLV

d irr a r fu a r d d pr dd m praoi pd m g i i i m i d a

PRUELGDGHVYrVHDQHFHVVLGDGHGHDPSOLDomRGDVSHVTXLVDV

a omba

&RPRREMHWLYRGHDYDOLDUDFRUUHODomRHQWUHKLSRWLUHRLGLVPRH

d pr pi a a d d m ua m anr d Dpr d Bi(DB D r a ru m a

WrP VLGR HODERUDGRV FRP D ¿QDOLGDGH DYDOLDU VLQWRPDV GH

GHSUHVVmR 2 ,'% p XP GRV PDLV XWLOL]DGRV PXQGLDOPHQWH

a m m a rd bmd pa d a p i m éa r ii m pa i d g r d r ua d

3

O I O!

A r pr d d pr fu a r d d pi a im pa r d m i m p r d im i a r

DWHQGLGRVQRVDPEXODWyULRVGR&HQWURGH(VWXGRH3HVTXLVDHP

Ed i r g Ma bg ("E#E iud H pa U r anr Wa r "aCd (HUW " d U r dd Fd r d " rn (UF " d Sr d Ed i r g

H 'LDEHWHV 6(' GR +8:&8)& &RPSDUDU RV GDGRV

UHJLRQDLVFRPDTXHOHVFRQKHFLGRVGHRXWURVVHUYLoRVDWUDYpV

d r a rnr

$ %O O!

&' )' * +,-,' )t. -,

7UDWDVH GH XP HVWXGR WUDQVYHUVDO DQDOtWLFR UHDOL]DGR QR

SHUtRGRGHVHWHPEURGHDMDQHLURGH3URFHGHXVHj

i a

d dd a ré d a r a im pi a r

GHSURQWXiULRVPpGLFRVHDSOLFDomRGRTXHVWLRQiULRGR,'%

du ra

i ua méd i

/0 4t50 4, )-'4*6 7.)8,

#i a a r9:;< impd pr pa rd m pr mnr mu d rp d r m a r d im L a r= Ep rg ru pia r pi a imfu

a r d rm mu d rp rm

/04t504, )-''x6 7. )8,

Frm =iuCd d m a r pi a im pra r d m u im pa r d m d irr a d a r d ia m pr ioird a rd> d i pia a i ri g r

TXHQHFHVVLWHPGHDFRPSDQKDPHQWRUHJXODUKLSRSLWXLWDULVPR

WUDWDPHQWRFRPGURJDVTXHDIHWDPDVHFUHomRPHWDEROLVPR

bd pbdd u d r m a r d > u

GHDQWLGHSUHVVLYRVRXGHPHGLFDo}HVSVLTXLiWULFDV

?v@74@G8,-'-' ã0' ))8,

# r d pr d d pr f ua d

,QYHQWiULRGH'HSUHVVmRGH%HFN,'%RTXDOFRQVLVWHHPXP

TXHVWLRQiULRFRPSRVWRSRUTXHVW}HVGHP~OWLSODHVFROKD

UHVSRQGLGRSHORSUySULRSDFLHQWHRTXDOSRQWXDDJUDYLGDGH

d i du m d 9 a m d m u m id

D SRQWRV VHQGR D DXVrQFLD GH VLQWRPDV H D SUHVHQoD

GHVLQWRPDVJUDYHV3DUDFDGDTXHVWmRRVSDUWLFLSDQWHVHUDP

VROLFLWDGRVDHVFROKHUDD¿UPDomRTXHPHOKRUGHVFUHYLDVHXV

VHQWLPHQWRVQD~OWLPDVHPDQD2HVFRUHWRWDOPi[LPRpGH

pa U mpa u mC md 9pa fi d rd i m m a fr rp rpr dd pr

3J K

V@04Nv'4)

#a u DB

3HU¿OGR76+

ŶĄůŝƐĞĞƐƚĂơƐƟĐĂ

$¿PGHFDUDFWHUL]DUDSRSXODomRGHFDGDJUXSRHFRPSDUDU

gu m iri a rC a i f rd n

d i r a d

PHGLo}HV GH IUHTXrQFLD TXDQGR D YDULiYHO IRL TXDOLWDWLYD H

PpGLD H VXDV YDULDo}HV TXDQGR D YDULiYHO IRL TXDQWLWDWLYD

1D FRPSDUDomR GDV YDULiYHLV LQGHSHQGHQWHV TXDOLWDWLYDV IRL

XWLOL]DGRRWHVWHGRTXLTXDGUDGRGH3HDUVRQ

$V YDULiYHLV TXDQWLWDWLYDV IRUDP WHVWDGDV SDUD QRUPDOLGDGH

SHORWHVWHGH6KDSLUR:LON3DUDDVYDULiYHLVLQGHSHQGHQWHV

pr d rmdd f d m g dd d roi d g ru p ua d a a L P Dd mg dd d fr a r gru p f a a d

SRU PHLR GH $129$ (P FDVR GH QmR FRPSURYDomR GD

m g dd p a a L P d fr a r rn d pd a f iiu d ua d a a

GH :HOFK $ GLVWLQomR HQWUH DV YDULiYHLV TXDQWLWDWLYDV VHP

QRUPDOLGDGHIRLYHUL¿FDGDSHORWHVWHGH0DQQ:KLWQH\

!QRO!

# ra iprm d aud T p i a d g ru p im pa rd m pr mnr d g ru p ia r X

KRXYH GLIHUHQoDV HSLGHPLROyJLFDV HQWUH DV GXDV SRSXODo}HV

(3)

¡¢ £ ¤¥ ¦¡¢¤ ¢ § § ¨

©ª ¦¦£¡ ¥ ¦ ¨¡¢ ¥ § § ¨ «©ª¬¥ ¥ ¨¤¡ ¥ ¥ ¨ ¢¡¦¥ § ¢¤ ® ¯¬° ¥¡§ ¢¤¡§ ¨ § ¢¦¥ ±°²³´ª ¨¦ ¡ § § §§§ ²µ±¶·´¸ ¢¦ ¢¡¢ ¥ ¤¡¨¥ § §¤ ¹º»¼½º¾¿´À ´ÁÂ¶ÁÃ

Ä ÅÆÇÈ ÉÊËÌ Æ ÍÆ ÎÏÐ ÈÑ ÒÑ Ó Ô ÍÕ Ê ÍÑ Ö×ØÖ Ù ÖÚØÛ ÇÆ ÜÝÉÅÆ ÞÕ ÅÆÈÕ ÝÑ ÆÕ ÍÕ ßÓ ÆàÑÍÑáØ âÙäØÛÇÆÜÝÉÅÆå ÆÇÈ ÝÆæÑçÅèêØ êâëì

*Ui¿FR4XDQGRREVHUYDPRVRYDORUGH76+UHODFLRQDGR

j SUHVHQoD GH GHSUHVVmR ,'% ! SHUFHEHPRV TXH QmR

ÞÆÉÒÑÝÑ æ ÊËÌÆÑÇÈÝÑÇí ÒÑ Õßß ÔÝÕ å ÆßÓ ÊÕ ÆÝÑßÍÑîï ðÑÅÆÇÈ ÉÊ ËÌ Æ

PDLVDOWDQR,'%*Ui¿FR)RLDYDOLDGDDTXDQWLGDGHGH

SDFLHQWHVFRPSRQWXDomRGR,'%PDLRUTXHFRPGR

JUXSRKLSRWLUHRLGLVPRFRPSDUDGRFRPGRJUXSRFRQWUROH

çÅèêØÛ êâìç îÊñÑ æ ÊÛ ìò

*Ui¿FR

ÁÂ¶± ·ªÁó´Ã

*Ui¿FR

ôÀ²õ´®Â¶± ·ö ¢§ Ã

÷øùúûºüýøùøþÿ · Gû ø

,'%

± ·ö¢§

+LSRWLUHRLGLVPR

&RQWUROH

F bÁÃ

F bÁÃ F bÁÃ

D ÃO

C ÆÇÆÝÓÑ Ó Æß ÈÝ ÊÍÆØ ÇÌÆ ÆÕ ÑÇå ÆÇÈ ÝÊÍÊ ÍÕ Ñ ÝÑ ÇËÊ Ñ ÇÈ ÝÑ Æß ÜÝÉÅÆßØß ÉÜÑ ÝÕ ÇÍÆÇÌ ÆÞ ÊÒÑÝå ÆÝÝÑ æ ÊËÌ ÆÑ ÇÈ ÝÑÆÞÕ ÅÆÈÕ ÝÑÆÕ ÍÕ ßÓ Æ

WUDWDGR DGHTXDGDPHQWH H GHSUHVVmR 1R HQWDQWR SHUFHEHVH

TXHKRXYHXPDWHQGrQFLDDXPULVFRPDLRUGHGHSUHVVmRQR

ÜÝÉÅÆÞÕ ÅÆÈÕ ÝÑÆÕ ÍÕ ßÓ ÆòîÊ æÒÑaåÆÓÅÆÅÉæ Ê ËÌ ÆÓ ÊÕ ßÇÉÓ Ñ Ý ÆßÊØ

HVVDWHQGrQFLDSRGHULDVHUFRQ¿UPDGD

C ÆÇÒÑÇå Õ ÆÇÊæÓ Ñ ÇÈÑØÉÓÇí ÒÑ æß Ô ÝÕ å Æ ÍÑîï ðÍÑ ÇÈ ÝÆÍÊÊÕfÊ

GHUHIHUrQFLDGRODERUDWyULRWHPVLGRWRPDGDFRPRLQGLFDWLYR

GH WHUDSLD DGHTXDGD 1R HQWDQWR DSHVDU GH GRFXPHQWDomR

ÍÑ Çí ÒÑÕ ß ÇÆÝÓ ÊÕ ß ÍÑîï ðØ Ó ÉÕ È Æß ÅÊåÕ Ñ ÇÈÑ ß ÅÆÝ ÈÊ ÍÆÝÑß ÍÑ

KLSRWLUHRLGLVPRWUDWDGRVFRQWLQXDPTXHL[DQGRVHGHVLQWRPDV

ÝÑ æ Êå Õ ÆÇÊ ÍÆßÊ ÆÞÕ ÅÆÈÕ ÝÑ ÆÕ ÍÕ ßÓ ÆØÊ ÍÕ ÜÊØÍÕ ß Èd ÝñÕ ÆßåÆÜÇÕ ÈÕ ÒÆß ÑÍÑÞ ÉÓ ÆÝò

5

$QRUPDOLGDGHV WLUHRLGHDQDV WrP VLGR DVVRFLDGDV FRP D

RFRUUrQFLD GH GRHQoDV SVLTXLiWULFDV LQFOXLQGR GHSUHVVmR

6

9iULRV HVWXGRV YHP PRVWUDQGR XP DXPHQWR GR ULVFR GH

GHSUHVVmR WDQWR HP KLSR TXDQWR HP KLSHUWLUHRLGLVPR PDV

ÅÆÉåÆßÑß ÊñÑÊå Ñ ÝåÊÍÆßÑÑ Õ È ÆßÍÑÉÓ ÊÉÇËÌÆÈÕ ÝÑ ÆÕ ÍÑ Ê ÇÊ ÍÑ ÇÈ ÝÆÍÆßæÕ Ó Õ ÈÑßÇÆÝÓ ÊÕ ßÇÊÍÑ ÅÝÑßßÌ Æò

7

2VLQGLYtGXRVFRPKLSRWLUHRLGLVPRWLQKDP76+PpGLRPDLV

DOWRGRTXHRVFRQWUROHVDSHVDUGRVQtYHLVGH76+HVWDUHP

ÇÊÊÕfÊÇÆÝÓ Ê æÍÆ æ ÊñÆÝ ÊÈoÝÕ Æò Eß ÈÑß ÝÑß Éæ ÈÊ ÍÆßæÑ ÒÊÇÈ ÊÓ Ê

TXHVWmR VH XPD RWLPL]DomR GRV QtYHLV VpULFRV GH76+ SDUD

ÉÓ ÊÊÕfÊÇÆÝÓ Ê æÓ ÊÕ ßÑß È ÝÑ Õ È ÊÊÝÕ ÊÍÕ ÑÝÑ ÇË ÊÇÆßÝÑß Éæ È ÊÍÆß

HQFRQWUDGRV 9HUL¿FRXVH HQWUHWDQWR TXH QmR KRXYH

å ÆÝÝÑæ ÊËÌÆÑÇÈÝÑÇí ÒÑ ÕßÍÑîïðÓ ÊÕ ßÊæ È ÆßÑÅÆÇÈ ÉÊËÌÆÇÆÎÏÐ

PDLRUTXHQRVSDFLHQWHVDQDOLVDGRV

MÑÍÕ åÕ Ñ È Ê æò ÆñßÑ ÝÒÆÉØ Ñ Ó Ñß È ÉÍÆ ÍÑ å ÆÆÝÈÑ ÅÆÅÉæÊåÕ ÆÇÊæØ ÉÓÝÕ ßåÆÊ ÉÓ Ñ ÇÈ ÊÍÆÍÑß í ÇÍÝÆÓ ÑßÍÑ ÅÝÑßßÕ ÒÊßÑÓÕ ÇÍÕ Òí ÍÉÆß

(4)

FRP QtYHLV GH76+ QRUPDLVEDL[RV PRVWUDQGR TXH PHVPR

YDULDo}HV SHTXHQDV QD IXQomR WLUHRLGHDQD GHQWUR GD IDL[D

n'( )* + p' ,-(. * ) t -( . ) p'(t *nt -s -/ -. t ' s n'c' ) p'(t * ) -nt' */-t . 0'1

8

S* )2 -+ s -t *+1 t * ) 39) -nc 'nt( '2 ,-c( - )-nt' s

VLJQL¿FDWLYRV HP VWDWXV GH VD~GH H VRIULPHQWR SVLFROyJLFR

-) :; . n ,.0i,2' s p'( t*,'( -s ,- h. p't . ( -'. ,. s)' t (*t * ,' s c' ) p*( * ,' s c' ) <= c'nt (' + -s s-) ,' -n>* t. (-'. ,-*n*?

DQRV DVVLP FRPR SUHMXt]R HP IXQo}HV GH PHPyULD

HVSHFt¿FDV

@

K(*) -( -t *+1? p'( s2* 0 -v? -) - st 2 ,' c ' ) t 't * + ,- A1=: ;

SDUWLFLSDQWHVRTXDOWDPEpPXVRXR,'%SDUDDYDOLDomRGH

GHSUHVVmRFRQFOXLXTXHWUDWDPHQWRGHKLSRWLUHRLGLVPRDORQJR

SUD]RQmRHVWiDVVRFLDGRFRPSUHMXt]RGDIXQomRFRJQLWLYDH

h2 )'(,- p( -ss. 0'n*p' p2 +*>u'. ,' s* 1 B

W* + sh-t* +1?-)- st2 ,'

GXSORFHJRUDQGRPL]DGRFRQWURODGRWDPEpPQmRHQFRQWURX

GLIHUHQoD HP UHODomR D VLQWRPDV GH KLSRWLUHRLGLVPR EHP

HVWDU H TXDOLGDGH GH YLGD FRP SHTXHQRV DMXVWHV QD GRVH GH

OHYRWLUR[LQDHPSDFLHQWHVFRPKLSRWLUHRLGLVPRREMHWLYDQGR

ni0 -. s,-T SHp(rI. )''2* 3* . I','+. ). t -. n/ -(. '(,')9t' ,'

GHGRVDJHPTXDQGRFRPSDUDGRFRP76+SUy[LPRDROLPLWH

s2 p-(. '(,-n'( )* +. ,* ,-1 J

Lpp-+h'/ -t * +1 '3s-(0'2? -) - st2 ,' c +in. c' ( *n ,' ).v* ,'?

GXSORFHJR SODFHERFRQWURODGR QmR KDYHU YDQWDJHP VREUH

p+*c - 3' n* *,.>u' ,- T: * p* ('I -t . n* -) p*c. -nt - s c' )

GLVW~UELRGHSUHVVLYRPDLRUQmRUHIUDWiULR3HORFRQWUiULRQR

-st 2 ,'?** ,.>u ',-T:p*(-c-2c *2 s*(2 )*2 ) -nt '* p -n* sn' s -0 -nt' s*,0 -( s' s1

N P

Q ' ,- )' s ,-st *c *( *. n ,* 2 ) -st 2 ,' ( -c -nt - c' ) ,*,' s ,-*t -n>u'p(. )U(. *n*VnX +* t -(( *c ' ))*. s,-Y:1===. n ,. 0i,2' s

HPXVRGHWLUR[LQDRTXDOPRVWURXTXHDSUR[LPDGDPHQWH

. n. c. '2t -(*p.*c' )T SHn*/ *. I* s2 3c+in. c*Z [A=) Vm \]^1 NN m )* p(' p'(>u ' c'n s. ,-(U0 -+ ,- ss- s p*c . -nt -s p' ,-t -( s. ,'

WUDWDGDSRUFDXVDGHVLQWRPDVGHSUHVVLYRV2SUREOHPDWUD]LGR

c' ) -ss* p( Ut. c* _p( . ) -.( * ) -nt -?' s s.nt ' )* s,' s p*c . -nt - s su '. ) p('0 U0 -. s,-) -+h'(* (c ' )'t (*t * ) -nt'c ' )t .( 'I.n*? ( -s2 +t *n ,' -) . n s*t . s/*>u' c' ) ' t (* t * ) -nt ' - n -c - ss. ,* ,-,- * 2 )-nt',- ,' s- '2 t (*t *)-nt' s * +t -(n*t . 0' s -?*. n ,*? *

SUREDELOLGDGHGHDWUDVRVLJQL¿FDWLYRGRGLDJQyVWLFRFRUUHWRGH

,-p( - ssu 'c' )t( *t * ) -nt '* p( ' p(. * ,'1

(QWUHDVOLPLWDo}HVGRQRVVRHVWXGRSRGHPRVGHVWDFDUDVXD

n*t 2( -v*t( *n s0 -(s*+_h*0. ** p-n* s2 )*) -,. ,*,-T SH?,* ,' s

GHSUpHSyVWUDWDPHQWRQmRHVWDYDPGLVSRQtYHLVHQmRKDYLD

LQIRUPDo}HV DFHUFD GD GXUDomR GR KLSRWLUHRLGLVPR DQWHV GR

.nic. ','t (* t*) -nt '1T*) 39)nu '/'.p' ssi0 - +*0*+. * ((-+*>u'

FDXVDHIHLWR HQWUH KLSRWLUHRLGLVPR WUDWDGR H SUHVHQoD GH

GHSUHVVmR SRGHPRV DSHQDV UHODWDU DVVRFLDo}HV TXH SRGHP

/'( )*(*3* s-p* (*- st2 ,' s/ 2t 2( ' s1

`. n* + ) -nt -? nu' (* st ( -* )' s n' ss' s .n ,. 0i,2' s c 'nt( ' +-p*(* h. st r(. */* ). +.* (,- ,' -n>* t. ( -'. ,-*n* '2 p( -s-n>*

,-DQWLFRUSRV DQWL732 H p SRVVtYHO TXH SRGHUtDPRV HQFRQWUDU

PDLRUHV GLIHUHQoDV HQWUH RV GRLV JUXSRV VH LQGLYtGXRV DQWL

732 SRVLWLYRV QR JUXSR FRQWUROH WLYHVVHP VLGR H[FOXtGRV

Mi TXH YiULDV GRHQoDV DXWRLPXQHV WHP VLGR DVVRFLDGDV FRP

2 ) (. sc' *2 ) -nt * ,',- ,- p( -ssu'1 NgjNk

Q 'p-t * +1? - )-st 2 ,' t( *n s0 -( s*+?

VXJHUH TXH D SUHVHQoD GH DQWLFRUSR DQWL732

-st U *ss'c .*,*c ' ) ,- p( -ssu ' - p' ,- t '(n*( )2 +h-(-s )*. s 02+n -( U0 -. s** p( - s-nt *(*,' -n>* 1

Nl

(P FRQFOXVmR QRVVR WUDEDOKR GHPRQVWURX TXH RV SDFLHQWHV

FRPKLSRWLUHRLGLVPRSULPiULRWUDWDGRVDGHTXDGDPHQWHQmR

WHPPDLRUIUHTXrQFLDGHGHSUHVVmRTXDQGRFRPSDUDGRVFRP

c'nt (' + -s c' ) /2n>u ' t . ( -'. ,-*n* n'( )* +1 q 'n s. ,-(*n ,' ' nw) -(' +. ). t*,' ,* *)'st (* * n* +. s* ,*?0 -)' s n'ss'-st 2 ,'

FRPRSLORWRQRQRVVRPHLRFRPRREMHWLYRGHVHUYLUFRPR

3* s-p*( *-st 2 ,' s)*. '( -s/ 2t2( ' s1

xy zy x{ |}~

0XUUD\&-/RSH]$'(YLGHQFHEDVHGKHDOWKSROLF\OHVVRQVIURP

WKH*OREDO%XUGHQRI'LVHDVH6WXG\6FLHQFH

'D\DQ &0 3DQLFNHU 9 +\SRWK\URLGLVP DQG GHSUHVVLRQ (XU

6DXHU 6 =LHJOHU 0 6FKPLWW 0 5DVFK DQDO\VLV RI D VLPSOL¿HG

9DQ GH 9HQ$& 0XQWMHZHUII -: 1HWHD0DLHU 57 GH 9HJW )

¡¡

3V\FKLDWU6FDQG

/WK\UR[LQHWUHDWHGK\SRWK\URLGVXEMHFWV7K\URLG

¢ª

%DXHU 0 RHW] 7 OHQQ 7 :K\EURZ 3& 7KH WK\URLG

¡ ¨

1HXURHQGRFULQRO

« ¥ £ § ¬ © ¥

SDWLHQWV1HXURSV\FKRELRORJ\

0HGLFL0'LUHN19LVVHU:(.RUHYDDU7,+RIPDQ$9LVVHU

¨ ¡ ©

GHSUHVVLRQ D SRSXODWLRQEDVHG FRKRUW VWXG\ - &OLQ (QGRFULQRO

0HWDE

:DOVK-3:DUG/&%XUNH9%KDJDW&,6KLHOV/+HQOH\'HW

¡ © ® © ¡

FKDQJHV LQ K\SRWK\URLG V\PSWRPV ZHOOEHLQJ RU TXDOLW\ RI OLIH

UHVXOWVRIDGRXEOHEOLQGUDQGRPL]HGFOLQLFDOWULDO-&OLQ(QGRFULQRO

0HWDE

$SSHOKRI %& %URXZHU -3 YDQ '\FN 5 )OLHUV ( +RRJHQGLMN

¯¨

¨

®

WUHDWPHQW RI PDMRU GHSUHVVLYH GLVRUGHU - &OLQ (QGRFULQRO 0HWDE

7D\ORU 31 ,TEDO $ 0LQDVVLDQ & 6D\HUV $ 'UDPDQ 06

¥

© ¡

(5)

ÑÒÓÒÔÕÖ×ØÙ

$UUXGD *$ &DUYDOKR &% +LVVD 05$YDOLDomR GD SUHYDOrQFLD GH GHSUHVVmR QR SDFLHQWH FRP KLSRWLUHRLGLVPR 5HY 0HG 8)& MDQ

MXQ

ÚÛÜÝÞßàÝá Ýßâãäß åæ áçÞèéêàç áëìíîáïÞ âÞê åßàßç áÝðññß åò á ß ã Þ âÜ óìãé ðôô ìñðãí ðñ õß öåßàà ðé ñ÷ ðñè åßÞàß õ Þ ñãðöøéà öøé âðöðõ

DXWRDQWLERGLHV$FWD3V\FKLDWU6FDQG

9DOW\VGyWWLU 67 *XGEM|UQVVRQ % /LQGTYLVW 8 +lOOJUHQ 5

+HWWD-$Q[LHW\DQGGHSUHVVLRQLQSDWLHQWVZLWKSULPDU\6M|JUHQV

V\QGURPH-5KHXPDWRO

3RS9-0DDUWHQV/+/HXVLQN*9DQ6RQ0-.QRWWQHUXV$$

ùÞ åõóÝáßãÞ âÜóåßÞ ìãé ðôô ìñßãøíåé ðõõíà úìñè ãðé ñÞ ñõõß öåßàà ðé ñ

Avaliação da prevalência de depressão no paciente com

ŚŝƉŽƟƌĞŽŝĚŝƐŵŽ

ƐƐĞƐƐŵĞŶƚ ŽĨ ƚŚĞ ƉƌĞǀĂůĞŶĐĞ ŽĨ ĚĞƉƌĞƐƐŝŽŶ ŝŶ ƚŚĞ ƉĂƟĞŶƚ ǁŝƚŚ

VLGR GLItFLO GH GH¿QLU Mi TXH RV HVWXGRV DFHUFD GR WHPD PRVWUDP UHVXOWDGRV FRQÀLWDQWHV 2EMHWLYRXVH DYDOLDU DWUDYpV GH

HVWXGRWUDQVYHUVDODQDOtWLFRDSUHVHQoDGHGHSUHVVmRHPSDFLHQWHVFRPKLSRWLUHRLGLVPRSULPiULRWUDWDGRVDGHTXDGDPHQWHFRP

SRQWXDomRPDLVDOWDQR,'%1mRIRLHQFRQWUDGDGLIHUHQoDVLJQL¿FDWLYDHQWUHRVJUXSRVVXJHULQGRQmRKDYHUFRUUHODomRHQWUHR

KLSRWLUHRLGLVPRWUDWDGRDGHTXDGDPHQWHHGHSUHVVmRDSHVDUGHWHUVLGRREVHUYDGDXPDWHQGrQFLDDXPULVFRPDLRUGHGHSUHVVmR

QRJUXSRKLSRWLUHRLGLVPR&RQVLGHUDQGRRQ~PHUROLPLWDGRGDDPRVWUDHRVGDGRVFRQÀLWDQWHVVmRQHFHVViULRVPDLVHVWXGRVFRP

SRSXODomRPDLVQXPHURVDSDUDFRQ¿UPDURXQmRHVVHVDFKDGRV

GLI¿FXOWWRGH¿QHVLQFHVWXGLHVRQWKHVXEMHFWVKRZFRQÀLFWLQJUHVXOWV7KHREMHFWLYHZDVWRHYDOXDWHWKURXJKDQDO\WLFDOFURVV

QRVLJQL¿FDQWGLIIHUHQFHEHWZHHQWKHJURXSVVXJJHVWLQJQRFRUUHODWLRQEHWZHHQK\SRWK\URLGLVPWUHDWHGSURSHUO\DQGGHSUHVVLRQ

VL]HDQGWKHFRQÀLFWLQJGDWDPRUHVWXGLHVDUHQHHGHGZLWKODUJHUSRSXODWLRQWRFRQ¿UPRUQRWWKHVH¿QGLQJV

&RQÀLWRGHLQWHUHVVHV

1mRKiTXDOTXHUFRQÀLWRGHLQWHUHVVHVSRUSDUWHGHTXDOTXHUXPGRVDXWRUHV

SHOD2UJDQL]DomR0XQGLDOGH6D~GHGHWRUQDUVHDVHJXQGD

QDWXUH]D GHVVD UHODomR H R TXH D GHWHUPLQD QmR WHUHP VLGR

FRQYLQFHQWHPHQWH SURYDGDV 2EVHUYDo}HV DFHUFD GH RQGH

R XVR WHUDSrXWLFR GH KRUP{QLRV WLUHRLGHDQRV QR PDQHMR GD

GHSUHVVmRHDVDSDUHQWHVDQRUPDOLGDGHVQRHL[RKLSRWiODPR

KLSy¿VHWLUHyLGHGHLQGLYtGXRVFRPGHSUHVVmR

1R%UDVLOSRXFRVHVWXGRVSRSXODFLRQDLVWrPVLGRIHLWRVFRPD

¿QDOLGDGHGHLQYHVWLJDUDRFRUUrQFLDGHGHSUHVVmRHPSDFLHQWHV

FRP GLVIXQo}HV WLUHRLGLDQDV FRPR KLSRWLUHRLGLVPR 7HQGR

HP YLVWD DV GLYHUVDV HYLGrQFLDV HP HVWXGRV LQWHUQDFLRQDLV

PRUELGDGHVYrVHDQHFHVVLGDGHGHDPSOLDomRGDVSHVTXLVDV

&RPRREMHWLYRGHDYDOLDUDFRUUHODomRHQWUHKLSRWLUHRLGLVPRH

WrP VLGR HODERUDGRV FRP D ¿QDOLGDGH DYDOLDU VLQWRPDV GH

GHSUHVVmR 2 ,'% p XP GRV PDLV XWLOL]DGRV PXQGLDOPHQWH

DWHQGLGRVQRVDPEXODWyULRVGR&HQWURGH(VWXGRH3HVTXLVDHP

H 'LDEHWHV 6(' GR +8:&8)& &RPSDUDU RV GDGRV

UHJLRQDLVFRPDTXHOHVFRQKHFLGRVGHRXWURVVHUYLoRVDWUDYpV

7UDWDVH GH XP HVWXGR WUDQVYHUVDO DQDOtWLFR UHDOL]DGR QR

SHUtRGRGHVHWHPEURGHDMDQHLURGH3URFHGHXVHj

GHSURQWXiULRVPpGLFRVHDSOLFDomRGRTXHVWLRQiULRGR,'%

TXHQHFHVVLWHPGHDFRPSDQKDPHQWRUHJXODUKLSRSLWXLWDULVPR

WUDWDPHQWRFRPGURJDVTXHDIHWDPDVHFUHomRPHWDEROLVPR

GHDQWLGHSUHVVLYRVRXGHPHGLFDo}HVSVLTXLiWULFDV

,QYHQWiULRGH'HSUHVVmRGH%HFN,'%RTXDOFRQVLVWHHPXP

TXHVWLRQiULRFRPSRVWRSRUTXHVW}HVGHP~OWLSODHVFROKD

UHVSRQGLGRSHORSUySULRSDFLHQWHRTXDOSRQWXDDJUDYLGDGH

D SRQWRV VHQGR D DXVrQFLD GH VLQWRPDV H D SUHVHQoD

GHVLQWRPDVJUDYHV3DUDFDGDTXHVWmRRVSDUWLFLSDQWHVHUDP

VROLFLWDGRVDHVFROKHUDD¿UPDomRTXHPHOKRUGHVFUHYLDVHXV

VHQWLPHQWRVQD~OWLPDVHPDQD2HVFRUHWRWDOPi[LPRpGH

3HU¿OGR76+

ŶĄůŝƐĞĞƐƚĂơƐƟĐĂ

$¿PGHFDUDFWHUL]DUDSRSXODomRGHFDGDJUXSRHFRPSDUDU

PHGLo}HV GH IUHTXrQFLD TXDQGR D YDULiYHO IRL TXDOLWDWLYD H

PpGLD H VXDV YDULDo}HV TXDQGR D YDULiYHO IRL TXDQWLWDWLYD

1D FRPSDUDomR GDV YDULiYHLV LQGHSHQGHQWHV TXDOLWDWLYDV IRL

XWLOL]DGRRWHVWHGRTXLTXDGUDGRGH3HDUVRQ

$V YDULiYHLV TXDQWLWDWLYDV IRUDP WHVWDGDV SDUD QRUPDOLGDGH

SHORWHVWHGH6KDSLUR:LON3DUDDVYDULiYHLVLQGHSHQGHQWHV

SRU PHLR GH $129$ (P FDVR GH QmR FRPSURYDomR GD

GH :HOFK $ GLVWLQomR HQWUH DV YDULiYHLV TXDQWLWDWLYDV VHP

QRUPDOLGDGHIRLYHUL¿FDGDSHORWHVWHGH0DQQ:KLWQH\

KRXYH GLIHUHQoDV HSLGHPLROyJLFDV HQWUH DV GXDV SRSXODo}HV

*Ui¿FR4XDQGRREVHUYDPRVRYDORUGH76+UHODFLRQDGR

j SUHVHQoD GH GHSUHVVmR ,'% ! SHUFHEHPRV TXH QmR

PDLVDOWDQR,'%*Ui¿FR)RLDYDOLDGDDTXDQWLGDGHGH

SDFLHQWHVFRPSRQWXDomRGR,'%PDLRUTXHFRPGR

JUXSRKLSRWLUHRLGLVPRFRPSDUDGRFRPGRJUXSRFRQWUROH

*Ui¿FR

*Ui¿FR

,'%

+LSRWLUHRLGLVPR

&RQWUROH

WUDWDGR DGHTXDGDPHQWH H GHSUHVVmR 1R HQWDQWR SHUFHEHVH

TXHKRXYHXPDWHQGrQFLDDXPULVFRPDLRUGHGHSUHVVmRQR

HVVDWHQGrQFLDSRGHULDVHUFRQ¿UPDGD

GHUHIHUrQFLDGRODERUDWyULRWHPVLGRWRPDGDFRPRLQGLFDWLYR

GH WHUDSLD DGHTXDGD 1R HQWDQWR DSHVDU GH GRFXPHQWDomR

KLSRWLUHRLGLVPRWUDWDGRVFRQWLQXDPTXHL[DQGRVHGHVLQWRPDV

$QRUPDOLGDGHV WLUHRLGHDQDV WrP VLGR DVVRFLDGDV FRP D

RFRUUrQFLD GH GRHQoDV SVLTXLiWULFDV LQFOXLQGR GHSUHVVmR

9iULRV HVWXGRV YHP PRVWUDQGR XP DXPHQWR GR ULVFR GH

GHSUHVVmR WDQWR HP KLSR TXDQWR HP KLSHUWLUHRLGLVPR PDV

2VLQGLYtGXRVFRPKLSRWLUHRLGLVPRWLQKDP76+PpGLRPDLV

DOWRGRTXHRVFRQWUROHVDSHVDUGRVQtYHLVGH76+HVWDUHP

TXHVWmR VH XPD RWLPL]DomR GRV QtYHLV VpULFRV GH76+ SDUD

,'%

%DXHU 0 RHW] 7 OHQQ 7 :K\EURZ 3& 7KH WK\URLG

+HWWD-$Q[LHW\DQGGHSUHVVLRQLQSDWLHQWVZLWKSULPDU\6M|JUHQV