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ABSTRACT: Controversy still exists over the independent role of psychosocial factors in acute myocardial infarction (AMI). This study aimed to compare psychometric indices in Portuguese patients surviving a first episode of AMI and a community sample free of AMI.
A community-based, case-control study. The study sample included 153 male patients with a first episode of AMI and 156 male controls randomly selected from the community.
Information on demographic, social, medical and behavioural characteristics was obtained using a structured questionnaire; anthropometric, blood pressure, and serum measurements were performed, and the psychometric evaluation was obtained using a self-evaluation questionnaires (Bortner scale, Beck Depression Inventory, SCL-90-R, Psychological General Well-Being and the Nottingham Health Profile).
Cases of AMI more often exhibited type A behaviour (15.4 +/- 3.0 versus 14.7 +/- 2.7, P = 0.041), had more depressive symptoms (10.8 +/- 8.0 versus 8.6 +/- 8.0, P = 0.005) and showed worse scores on general well-being (68.4 +/- 17.7 versus 76.6 +/- 16.2, P < 0.001) than controls. Cases were significantly different from controls in terms of years of education (6.7 +/- 4.4 versus 9.0 +/- 4.7 years, P < 0.001), hypertension (43.1% versus 30.1%, P = 0.024), dislipidaemia (43.8% versus 34.0%, P = 0.038), type I obesity (53.6% versus 42.3%, P = 0.045), smoking (54.1% versus 26.5%, P < 0.001), no practise of exercise (68.5% versus 50.3%, P = 0.002) and presence of non-insulin-dependent diabetics (16.3% versus 6.4%, P = 0.010). After adjusting for such factors a similar set of significant psychometric results was found.
Type A behaviour, depression and lower levels of well-being and quality of life, independent of other cardiovascular risk factors, were significant features of AMI cases.
Journal of Cardiovascular Risk 06/1999; 6(3):157-62.
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ABSTRACT: In a community sample of 102 Portuguese white women we evaluated the relationship between osteoporosis and indexes of psychopathology and well-being. Depressive symptoms were assessed by the Beck Depression Inventory (BDI), psychopathology by the Hopkins Symptom Checklist-90 Revised (SCL-90-R), and quality of life using the Psychological General Well-Being Index. A questionnaire comprising social, demographic, clinical, and behavioral characteristics was also used. The sample prevalence of osteoporosis was 47.1%. Women with osteoporosis presented significantly higher scores on the total BDI (16+/-9 vs. 13+/-10, p=0.045) and lower scores in the hostility (0.8+/-0.6 vs. 1.2+/-0.7, p=0.012) and phobic anxiety (1.1+/-0.8 vs. 1.5+/-0.9, p=0.041) subscales of the SCL-90-R. No differences were found regarding mean general well-being scores (62+/-17 vs. 64+/-19, p=0.665). This study showed that women with osteoporosis have significantly higher levels of depressive symptoms and a corresponding higher prevalence of depression, independent of other factors strongly associated with osteoporosis, such as age or body mass index.
Journal of Psychosomatic Research 02/1999; 46(1):29-35. · 3.30 Impact Factor
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ABSTRACT: It has been hypothesized that white-coat hypertensives (WCHs) have lower cardiovascular risk than sustained hypertensives (HTs), but higher emotional reactivity. We evaluated 92 HT patients (clinic and daytime BP>140/90 mmHg), 52 WCHs (clinic BP>140190 and ambulatory daytime BP<134/ 85 mmHg), and 74 normotensive subjects (NTs, clinic BP<140/90 and ambulatory daytime BP<134/85 mmHg), aged between 24 and 72 years, and matched for educational level, age, gender, and weight for depression, psychopathology, well-being, and quality of life. HTs showed worse scores than WCHs and NTs on most of the psychological variables; no differences were found between WCHs and NTs except on physical mobility. Daytime BP variability was HTs>WCHs>NTs, whereas nighttime BP variability was HTs>WCHs=NTs. We conclude that HTs have worse psychological profiles than the other two groups. WCHs and NTs have similar psychological profiles, although WCHs have a higher daytime BP variability, which is not associated with higher emotional reactivity.
Journal of Psychosomatic Research 01/1999; 46(1):15-27. · 3.30 Impact Factor
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ABSTRACT: Psychosocial factors have been considered important in the initiation of drug abuse and seem to affect its clinical course and outcome. Several studies have reported psychopathology, namely depression, to be consistently high in addiction. The aim of this investigation was to evaluate the prevalence of depression and its relationship to the severity of drug abuse in a Portuguese sample of drug addicts.
Two hundred and eighty-five drug addicts (23 women and 262 men, aged between 16 and 41 years old), diagnosed according to the DSM-IV criteria, were contacted during their first visit for treatment at public health centres. Social, demographic and behavioural characteristics of the study sample were obtained by interview using a structured questionnaire. The severity of drug abuse was evaluated using a Portuguese version of the Drug Abuse Screening Test, and depression was assessed by the Zung self-rating depression scale.
The prevalence of depression was 51.2% and was higher in females than males (77.8 vs. 48.7%, p = 0.034). A significant correlation was also found between the severity of drug abuse and depression scores, which was also stronger in females (r = 0.53 vs. r = 0.24).
This study showed a high prevalence of depression in drug addicts, regardless of the type and duration of drug abuse, and a significant association between depression and severity of drug addiction.
Psychopathology 33(3):103-9. · 1.82 Impact Factor
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ABSTRACT: Psychosocial characteristics might contribute to a more comprehensive understanding of cardiovascular disease as it is increasingly recognised that biomedical risk factors do not fully explain its dynamics. This study aimed to describe psychometric indexes in a Portuguese community sample relating them to known cardiovascular disease risk factors.
Anthropometric, blood pressure, serum measurements and information on demographic, social, medical and behavioural characteristics were obtained for 215 women and 156 men. Self-administered questionnaires were used for the psychometric evaluation (Bortner scale, Beck Depression Inventory, Hopkins Symptom Distress Checklist 90-Revised, Psychological General Well-Being and the Nottingham Health Profile, NHP).
There were significant differences according to gender regarding almost every psychometric dimension assessed. After adjusting for the presence of different biomedical risk factors, significant decreasing mean behaviour pattern scores were found with increasing age. Mean depression scores were significantly higher in women and in individuals with lower educational level. As to general psychological well-being, the highest scores were obtained for men and individuals with higher educational level. For the assessed dimensions of quality of life, as well as indexes of psychopathology, men scored better than women. No significant differences in mean scores of behaviour pattern, depression, psychological general well-being and dimensions of NHP were found according to the presence of an increasing number of cardiovascular risk factors.
The study shows that the clustering of multiple biomedical risk factors does not result in additive deleterious psychological effects and that psychometric indexes are mainly dependent on gender and education, common confounders in most studies evaluating cardiovascular risk factors.
Psychotherapy and Psychosomatics 69(5):261-74. · 6.28 Impact Factor
