R Coelho

University of Porto, Oporto, Porto, Portugal

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Publications (18)30.69 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Despite the mortality and morbidity burden associated with cardiovascular disease in women, there is insufficient knowledge regarding gender specificities in both biomedical and psychosocial domains. Gender differences in both pathophysiology and biological risk factors might explain distinct prevalence rates, symptom profiles and even medical outcomes, but gender-related specificities regarding psychosocial risk factors might further explain this. The authors review the key issues on this topic and outline suggestions for future research. Ultimately, a better understanding of this matter will translate not only cardiovascular disease.
    Cardiology in review 07/2013;
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    ABSTRACT: Quality of life is a major goal in the context of preventive and therapeutic cardiology. It is important, both as an outcome measure in clinical trials of congestive heart failure (CHF) and as a consideration in individual physicians' therapeutic decisions. In this article, quality of life concepts are reviewed, methods of measurement are explored and clinically significant changes on prognosis are discussed. There is a need for more research which is based on carefully selected measures of quality of life chosen as being of particular importance to patients and to the hypotheses being tested.
    Clinical Practice and Epidemiology in Mental Health 11/2005; 1:19.
  • Rui Coelho, Isabel Amorim, Joana Prata
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    ABSTRACT: The authors examined the relationship between coping style and perceived quality of life in patients with non-insulin-dependent diabetes mellitus. Diabetic patients (N=123) and nondiabetic comparison patients (N=124) treated at a Portuguese health center completed the Nottingham Health Profile, a quality-of-life measure. The diabetic patients also completed the Coping Responses Inventory, a measure of coping styles. In both groups, female subjects had poorer quality-of-life ratings than male subjects. Diabetic patients were more likely to regard diabetes and the consequent changes in lifestyle as a threat than as a challenge. A greater proportion of diabetic patients used avoidance coping styles, which overall were related to worse quality of life, than used active confrontation coping styles. Coping style was significantly correlated with several dimensions of quality of life in diabetic patients.
    Psychosomatics 01/2003; 44(4):312-8. · 1.73 Impact Factor
  • R Coelho, A Martins, H Barros
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    ABSTRACT: Purpose: Depressive disorders (DD) in adolescence are often misdiagnosed and under-recognised. A major clinical problem regards the high rate of co-morbidity with other disorders, namely substance abuse. The aim of this study was to assess the discriminative power of the Beck Depression Inventory II (BDI-II) to characterise specific social-demographic variables related to DD in adolescence. A Portuguese version of the BDI-II and a social-demographic questionnaire were administered to 775 Portuguese adolescents (312 males, 463 females; mean age: 16.9 years); 83 adolescents performed a clinical interview following DSM-IV criteria. Mean BDI-II Portuguese version (BDI-II-P) total score was 10.31 (standard deviation: 8.4), with females reporting more depressive symptoms than males (P < 0.001). Low academic achievement, sleep disturbances, and alcohol consumption were consistently associated with depressive symptoms for both genders. Higher tobacco consumption was significantly associated with depressive symptoms in females. Familial factors did not appear to be associated with depressive symptoms in males. However, a higher frequency of siblings, having separated parents as well as a more extreme perception of the mother's educational style were consistently associated with depressive symptoms in females. The BDI-II-P showed discriminative power to characterise social-demographic variables related to DD especially in adolescent females.
    European Psychiatry 07/2002; 17(4):222-6. · 3.29 Impact Factor
  • R Coelho, E Ramos, J Prata, H Barros
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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 01/2000; 69(5):261-74. · 9.38 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 01/2000; 33(3):103-9. · 1.62 Impact Factor
  • Revista Portuguesa de Psicossomática. 01/2000; 2(1):0-.
  • European Journal of Heart Failure 01/2000; 2. · 5.25 Impact Factor
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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. · 3.27 Impact Factor
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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 - J PSYCHOSOM RES. 01/1999; 46(1):29-35.
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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. · 3.27 Impact Factor
  • Journal of Psychosomatic Research 01/1999; 46(1). · 3.27 Impact Factor
  • Análise Psicológica. 12/1998; 16(4):667-674.
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    ABSTRACT: To evaluate the influence of psychological and psychopathological factors and quality of life on hypertension, its treatment and patient compliance. Case-control study. Primary Health Care Center in Oporto. Forty nine patients (pts) with essential hypertension (HT), 35 female and 14 male, mean ages: 52 +/- 11 yrs and 59 +/- 10 yrs, respectively, and 39 normotensive controls (NT)--18 female and 21 male, mean ages: 37 +/- 15 yrs and 42 +/- 15 yrs, respectively, were recruited from the same General Practice. Hypertension was classified according to the Joint National Committee criteria. The following psychometric evaluations were used: the Beck Depression Inventory, the Hopkins Symptom Distress Checklist, the Psychological General Well-Being Schedule and the Eysenck Personality Inventory. 1. The hypertensive pts differed from the normotensive pts as they scored significantly higher in somatization (p = 0.07), aggression/hostility (p = 0.036), index of psychological distress (p = 0.08) and, neuroticism (p = 0.09); 2. the hypertensive pts showed lower scores of quality of life (p = 0.019); 3. the biochemical parameters studied (uric acid, urea, creatinine, glicose, total cholesterol, HDL cholesterol, trigliceride, transaminases and gammaglutamil transferase) did not show statistically significant correlation with the psychological variables and quality of life items studied; 4. the electrocardiographic and echocardiographic alterations, corresponding to the severity of the clinical situation, were not associated with statistically significant differences in depression and quality of life; 5. the angiotensin converting enzyme inhibitor, the calcium antagonist and the beta-blockers showed no statistically significant influence on the psychological scores studied. However, pts receiving diuretics showed higher scores of somatization (p = 0.0008) and obsession/ compulsion (p = 0.02) and, lower scores of quality of life (p = 0.04); 6. a better compliance was associated with better psychological scores, and somatization scored with statistical significance (p = 0.03). The hypertensive pts differed from the normotensive pts as they scored significantly higher in aggression/hostility and lower in quality of life. No statistically significant differences were found among the psychological variables in the pts with cardiac involvement. A better compliance was associated with better psychological scores. The results of this study lead us to suggest that when treating pts with HT, the most appropriate therapeutic attitude should attempt to avoid both therapeutic withdrawal and lack of medical control.
    Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 12/1997; 16(11):873-83, 848. · 0.59 Impact Factor
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    ABSTRACT: A case-control study of coronary heart disease (CHD) was conducted in Oporto, Portugal. The cases series consisted of 100 consecutive patients with first time acute myocardial infarction who were admitted to the Coronary and Intermediate Care Units of a major teaching hospital. The community controls were 198 individuals without evidence of CHD by the Rose questionnaire and electrocardiography, selected by random digit dialing, with a participation rate of 70%. Data was collected by trained interviewers using a structured questionnaire and blood samples were obtained for selected laboratory data. The main analysis was made through unconditional logistic regression with calculations of odds ratios (OR). Age, OR: 1.5 (95% CI: 0.8-2.9), male gender, OR: 6.7 (3.6-12.3), family history of premature CHD, OR: 2.4 (1.4-4.3), diabetes, OR: 3.4 (1.6-7.4), antecedents of hypertension, OR:1.9 (1.1-3.1), history of high cholesterol levels, OR: 2.3 (1.4-3.9), high levels of physical activity, OR: 2.0 (0.9-4.1) and tobacco smoking, OR: 8.3 (3.8-18.5) were significant risk factors of acute myocardial infarction. After controlling for demographic variables and for the mutual confounding effects of the risk factors, the investigated factors that remained significantly associated with the risk of developing acute myocardial infarction were male gender, OR: 17.3 (4.8-62.3), family history of CHD, OR: 3.6 (1.4-9.6), diabetes, OR: 4.2 (1.0-18.1), high cholesterol levels OR: 2.7 (1.2-6.1) and smoking habits, OR: 7.7 (1.8-32.4). A negative association with high education levels was significant after controlling for all the variables, OR: 0.01 (0.01-0.5).
    Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 10/1997; 16(9):695-702, 664. · 0.59 Impact Factor
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    ABSTRACT: The aim of this study was to assess the prevalence, awareness, treatment and control of hypertension among subjects above the age of 39 years living in the urban area of Oporto, Portugal. One hundred and seventy seven individuals from the community were selected by random digit dialing. Each subject was asked about his/her personal history of hypertension, antihypertensive treatment and had his/her blood pressure measured. The prevalence of hypertension was 57.1%, defined by systolic blood pressure (SBP) > or = 140 mm Hg and/or diastolic blood pressure (DBP) > or = 90 mm Hg and/or administration of current the antihypertensive medication. If the values defining hypertension were SBP > or = 160 mm Hg, and DBP > or = 95 mm Hg the prevalence would be 37.9%. The overall prevalence of hypertension was higher in females, but a slightly higher non significant value was found in males in the fifth and sixth decades. Among hypertensives, 62.7% were aware of their condition, 56.7% were treated, 84.2% of hypertensives treated were controlled (SBP < 160 mm Hg and DBP < 95 mm Hg) and 44.7% were very well controlled (SBP < 140 mm Hg and DBP < 90 mm Hg). The question "Are you hypertensive?" had a sensitivity of 62.7%, a specificity of 83.6% and an accuracy of 75.7%. In the preliminary results of this study of an urban population with a high prevalence of hypertension, the awareness of hypertension is similar to that described in the United States of America twenty years ago, the percentage of hypertensives treated is similar to the American percentage fifteen years ago and the percentage of hypertensives treated and controlled is close to the current American percentage.
    Revista portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology: an official journal of the Portuguese Society of Cardiology 09/1997; 16(9):683-90, 663. · 0.59 Impact Factor
  • American Journal of Hypertension - AMER J HYPERTENS. 01/1997; 10(4).