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      Major depressive episode among university students in Southern Brazil

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          ABSTRACT

          INTRODUCTION

          Depression is the leading cause of disability around the world, and it has been increasingly affecting young people. This study evaluates the prevalence and factors associated with major depression in university students, with emphasis on the influence of the academic field, chosen study area and the environment they are inserted.

          METHODS

          A census of students who entered the university in the first semester of 2017 was held at a university in Southern Brazil. The outcome of major depressive episode was evaluated using the Patient Health Questionnaire -9, considered when the individual had five or more depressive symptoms for at least one week. Its prevalence was estimated, and the associated factors were examined by the hierarchical multivariable analysis using the Poisson regression model.

          RESULTS

          A total of 32% (95% confidence interval 29.9–34.2) of university students presented a major depressive episode, and the problem was more frequent among women (prevalence ratio [PR] = 1.59); people aged 21 to 23 years (PR = 1.24); those with a family history of depression (PR = 1.27); minorities’ sexual orientation (homosexuals, PR = 1.64, and bisexuals, PR = 1.69); who lived with friends or colleagues (PR = 1.36); students in the area of applied social and human sciences (PR = 1.28), and linguistics, language and literature, and art (PR = 1.25). The worst academic performance (PR = 2.61), alcohol abuse (PR = 1.25), and illicit drug use (PR = 1.30) were also positively associated with major depressive episode.

          CONCLUSION

          In addition to individual, family, and behavioral aspects, already described as risk factors for major depressive episodes in the general population, academic aspects also influence the occurrence of depression among university students. Considering the high prevalence of major depressive episode and its negative impact on health, public and institutional policies are necessary to focus on students’ mental health promotion and care.

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          Most cited references24

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          Prevalence of Depression and Anxiety Among Bisexual People Compared to Gay, Lesbian, and Heterosexual Individuals:A Systematic Review and Meta-Analysis

          Over the past decade, evidence has accumulated to suggest that bisexual people experience higher rates of poor mental health outcomes compared to both heterosexual and gay/lesbian individuals. However, no previous meta-analyses have been conducted to establish the magnitude of these disparities. To address this research gap, we conducted a systematic review and meta-analysis of studies that reported bisexual-specific data on standardized measures of depression or anxiety. Of the 1,074 full-text articles reviewed, 1,023 were ineligible, predominantly because they did not report separate data for bisexual people (n = 562 studies). Ultimately, 52 eligible studies could be pooled in the analysis. Results indicate that across both outcomes, there is a consistent pattern of lowest rates of depression and anxiety among heterosexual people, while bisexual people exhibit higher or equivalent rates in comparison to lesbian/gay people. On the basis of empirical and theoretical literature, we propose three interrelated contributors to these disparities: experiences of sexual orientation-based discrimination, bisexual invisibility/erasure, and lack of bisexual-affirmative support. Implications for interventions to improve the health and well-being of bisexual people are proposed.
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            Stress, anxiety & depression among medical undergraduate students & their socio-demographic correlates

            Background & objectives: Presence of psychological morbidity in medical undergraduate students has been reported from various countries across the world. Indian studies to document this burden are very few. Therefore, the presence of depression, anxiety and stress among medical undergraduate students was assessed using a previously validated and standardized instrument, Depression Anxiety Stress Scale (DASS 42) and the associations with their socio-demographic and personal characteristics were identified. Methods: In a cross-sectional survey, a self-administered, pre-designed, pre-tested anonymous questionnaire including DASS 42 was used to collect information on basic socio-demographic (age, gender, semester) and personal characteristics (alcohol and tobacco use, academic performance). All students present on the day of survey were contacted for participation after obtaining informed written consent. Scores for each of the respondents over each of the sub-scales (Depression, Anxiety and Stress) were calculated as per the severity-rating index. Results: More than half of the respondents were affected by depression (51.3%), anxiety (66.9%) and stress (53%). Morbidity was found to be more in 5th semester students rather than students of 2nd semester. Females reported higher score as compared to their male counterparts. Perception of self assessment in academics was strongly associated with the higher score. Conclusions: A substantial proportion of medical undergraduate students was found to be depressed, anxious and stressed revealing a neglected area of the students’ psychology requiring urgent attention. Student counselling services need to be made available and accessible to curb this morbidity.
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              Sensibilidade e especificidade do Patient Health Questionnaire-9 (PHQ-9) entre adultos da população geral

              Com o objetivo de estudar a validade do Patient Health Questionnaire-9 (PHQ-9) no rastreio de episódio depressivo maior na população geral, conduziu-se um estudo de base populacional em Pelotas, Rio Grande do Sul, Brasil. Os domicílios foram sorteados por amostragem em múltiplos estágios, sendo os adultos (> 20 anos) convidados a participar. O padrão ouro foi a entrevista diagnóstica estruturada Mini International Neuropsychiatric Interview (MINI) aplicada por psiquiatras e psicólogos. Tanto o PHQ-9 quanto o MINI foram aplicados no domicílio. Em um total de 447 participantes (191 homens e 256 mulheres) a análise contínua identificou o ponto de corte > 9 como de máxima sensibilidade (77,5%; 61,5-89,2) e especificidade (86,7%; 83,0-89,9). Usando o algoritmo do teste, houve diminuição da sensibilidade para 42,5% (27,0-59,1), enquanto que a especificidade aumentou para 95,3% (92,8-97,2). O PHQ-9 mostrou-se apropriado para rastreamento de episódio depressivo maior. Pela maior sensibilidade, o PHQ-9 pontuado de forma contínua mostrou-se mais adequado do que o algoritmo para rastreamento de episódio depressivo maior na comunidade.
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                Author and article information

                Journal
                Rev Saude Publica
                Rev Saude Publica
                rsp
                Revista de Saúde Pública
                Faculdade de Saúde Pública da Universidade de São Paulo
                0034-8910
                1518-8787
                23 January 2020
                2020
                : 54
                : 11
                Affiliations
                [I ]orgnameUniversidade Federal de Pelotas orgdiv1Faculdade de Medicina orgdiv2Programa de Pós-graduação em Epidemiologia Pelotas RSBrasiloriginalUniversidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-graduação em Epidemiologia. Pelotas, RS, Brasil
                [II ]orgnameUniversidade Federal de Pelotas orgdiv1Faculdade de Medicina Pelotas RSBrasiloriginalUniversidade Federal de Pelotas. Faculdade de Medicina. Curso de graduação em Psicologia. Pelotas, RS, Brasil
                [I ]Brasiloriginal Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-graduação em Epidemiologia. Pelotas, RS, Brasil
                [II ]BrasiloriginalUniversidade Federal de Pelotas. Faculdade de Medicina. Curso de graduação em Psicologia. Pelotas, RS, Brasil
                Author notes
                Correspondence: Betina Daniele Flesch Rua: Marechal Deodoro, 1160, 3º piso – Centro Caixa Postal 464 / 96020-220 – Pelotas/RS Fone/Fax: +55 (53) 3284-1300 E-mail: betinaflesch@ 123456gmail.com

                Authors’ contribution: Study conception and planning: BDF, TNM, AGF. Data collection, analysis and interpretation: BDF, GMH, TNM, AGF. Manuscript development or revision: BDF, TNM, AGF. Approval of the final version: BDF, TNM, AGF. Public responsibility for the content of the article: BDF, GMH, TNM, AGF.

                Conflict of Interests: The authors declare no conflict of interest.

                Correspondência: Betina Daniele Flesch Rua: Marechal Deodoro, 1160, 3º piso – Centro Caixa Postal 464 / 96020-220 – Pelotas/RS Fone/Fax: +55 (53) 3284-1300 E-mail: betinaflesch@gmail.com

                Contribuição dos Autores: Concepção e planejamento do estudo: BDF, TNM, AGF. Coleta, análise e interpretação dos dados: BDF, GMH, TNM, AGF. Elaboração ou revisão do manuscrito: BDF, TNM, AGF. Aprovação da versão final: BDF, TNM, AGF. Responsabilidade pública pelo conteúdo do artigo: BDF, GMH, TNM, AGF.

                Conflito de Interesses: Esse trabalho não possui conflitos de interesses a declarar.

                Author information
                https://orcid.org/0000-0003-4245-3131
                https://orcid.org/0000-0003-3401-2547
                https://orcid.org/0000-0003-1281-9542
                https://orcid.org/0000-0001-6070-6214
                Article
                00210
                10.11606/s1518-8787.2020054001540
                6986868
                32022140
                61cd005c-d6b9-4eb5-ac24-490236b93e24

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 February 2019
                : 03 June 2019
                Page count
                Figures: 0, Tables: 4, Equations: 0, References: 36
                Categories
                Original Article

                students, psychology,higher education,depression, epidemiology,depressive disorder, epidemiology,risk factors,mental health,estudantes, psicologia,educação superior,depressão, epidemiologia,transtorno depressivo, epidemiologia,fatores de risco,saúde mental

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