Transtorno mental comum em familiares cuidadores de pacientes com demência
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Data
2018-02-26
Autores
Duarte, Evelise Saia Rodolpho
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: O envelhecimento populacional é um fenômeno mundial que está associado ao aumento da incidência de doenças crônico-degenerativas, como as demências. As demências desafiam não somente os pacientes, mas também seus cuidadores. Em geral, cuidar de idosos é uma responsabilidade que pertence à esfera familiar. Como consequência, familiares cuidadores estão em maior risco de adoecimento mental, resultando em depressão, sobrecarga, sintomas ansiosos e transtorno mental comum. Objetivo: O presente estudo tem por objetivo verificar a prevalência de TMC em familiares cuidadores de pacientes idosos com diagnóstico de demência rotineiramente acompanhados nos ambulatórios de geriatria do Centro de Saúde Escola da Faculdade de Medicina de Botucatu, UNESP. Métodos: Neste estudo transversal, aprovado pelo Comitê de Ética e Pesquisa da Faculdade de Medicina de Botucatu os instrumentos de avaliação utilizados foram: Self Reporting Questionnaire, Hospital Anxiety and Depression Scale, Zarit Burden Interview, Mini Exame do Estado Mental para cuidadores com 65 anos ou mais, além de questionário para coleta de dados sociodemográficos. A variável de desfecho foi “com transtorno mental comum”, definida como pontuação ≥ 7 no Self Reporting Questionnaire. As variáveis explanatórias foram de natureza sociodemográfica e clínica do cuidador. Resultados: A amostra foi composta por 90 cuidadores; 83 (92,2%) era do sexo feminino, 51 (56,7%) casada, 60 (66,7%) filho (a) e 62 (68,6%) possuíam alguma ocupação além de cuidar do idoso dementado. A média de idade da amostra foi 57,3 (± 11,7), enquanto a média de escolaridade foi de 9,5 (± 4,9) anos. Quanto às características clínicas da amostra, 62,2% dos cuidadores pontuaram para transtorno mental comum, 50% apresentou sintomas de ansiedade, 52,2% apresentou sintomas de depressão e 66,7% apresentou sobrecarga em algum nível. Os cuidadores com transtorno mental comum apresentaram escores maiores na Escala Hospitalar de Ansiedade e Depressão e Escala Zarit com associação estatisticamente significante (p<0,01). Não houve diferença estatisticamente significante quando comparados os dois grupos em relação às variáveis sexo, estado civil, trabalho e parentesco. A regressão logística mostrou que cuidadores com sintomas de ansiedade tiveram 15 vezes mais chances de apresentar transtorno mental comum (OR: 15,0; IC 95%: 3,5-71,2) e cuidadores com sintomas de depressão tiveram 8 vezes mais chances de apresentar transtorno mental comum (OR: 8,0; IC 95%: 2,1-31,1). Cuidadores com sobrecarga tiveram 7,2 vezes mais chances de apresentar transtorno mental comum (OR: 7,2; IC 95%: 1,9-27,2). Os cuidadores mais jovens foram 0,93 menos propensos a apresentar transtorno mental comum (OR: 0,93; IC 95%: 0,88-0,99). Conclusão: Os resultados encontrados demonstram que, na população estudada, existe alta prevalência de transtorno mental comum. Constatou-se a associação estatisticamente significante de transtorno mental comum com sobrecarga (moderada, moderada/grave e grave) e com sintomas ansiosos e sintomas depressivos.
Introduction: Population aging is a global phenomenon that is associated with an increase in the incidence of chronic-degenerative diseases, such as dementia. Dementia challenges not only patients but also their caregivers. In general, caring for the elderly is a responsibility that belongs to the family members. As a consequence, they are at increased risk of mental illness resulting in depressive and anxious symptoms characterized as common mental disorders, besides burden. Objective: The present study aims to verify the frequency of common mental disorders among family caregivers of elderly patients diagnosed with dementia routinely followed at a geriatric outpatients clinic of the “Centro de Saúde Escola”, Botucatu Medical School, UNESP. Methods: In this cross-sectional study, approved by the Ethics and Research Committee of Botucatu Medical School, UNESP the following assessment tools used were: Self Reporting Questionnaire, Hospital Anxiety and Depression Scale, Zarit Burden Interview, Mini Mental State Exam (for caregivers aged 65 years and older and questionnaire for the collection of sociodemographic data. The outcome variable was "to have common mental disorder”, defined as a score ≥ 7 on the Self Reporting Questionnaire. The explanatory variables were sociodemographic and clinical data of the caregiver. Results: 90 caregivers were evaluated; 83 (92.2%) were female, 51 (56.7%) were married, 60 (66.7%) were sons/daughters and 62 (68.6%) had some occupation besides caring for the demented elderly. The mean age was 57.3 (± 11.7) and the mean educational level was 9.5 (± 4.9) years. Regarding the clinical characteristics of the sample, 62.2% of the caregivers had ≥ 7 on Self Reporting Questionnaire, 50% had anxiety symptoms, 52.2% had depression symptoms and 66.7% burden at some level. Patients with common mental disorder showed higher scores on the Hospital Anxiety and Depression Scale (anxiety and depression) and Zarit Burden Interview scales, with a statistically significant association (p <0.01). There was no statistically significant difference when comparing the two groups in relation to gender, marital status, work and kinship. Logistic regression showed that caregivers with anxiety symptoms were 15 times more likely to present common mental disorder (OR: 15.0; 95% CI: 3.5-71.2) and caregivers with symptoms of depression were 8 times more likely to have common mental disorder (OR: 8.0; 95% CI: 2.1-31.1). Caregivers with burden were 7.2 times more likely to have common mental disorder (OR: 7.2; 95% CI: 1.9-27.2). Younger caregivers were 0.93 times less likely to have common mental disorder (OR: 0.93; 95% CI: 0.88-0.99). Conclusion: The results show that, among the population studied, there was a high prevalence of common mental disorder. We found a significant association of common mental disorder with burden (moderate, moderate/severe and severe) and with anxiety and depression symptoms.
Introduction: Population aging is a global phenomenon that is associated with an increase in the incidence of chronic-degenerative diseases, such as dementia. Dementia challenges not only patients but also their caregivers. In general, caring for the elderly is a responsibility that belongs to the family members. As a consequence, they are at increased risk of mental illness resulting in depressive and anxious symptoms characterized as common mental disorders, besides burden. Objective: The present study aims to verify the frequency of common mental disorders among family caregivers of elderly patients diagnosed with dementia routinely followed at a geriatric outpatients clinic of the “Centro de Saúde Escola”, Botucatu Medical School, UNESP. Methods: In this cross-sectional study, approved by the Ethics and Research Committee of Botucatu Medical School, UNESP the following assessment tools used were: Self Reporting Questionnaire, Hospital Anxiety and Depression Scale, Zarit Burden Interview, Mini Mental State Exam (for caregivers aged 65 years and older and questionnaire for the collection of sociodemographic data. The outcome variable was "to have common mental disorder”, defined as a score ≥ 7 on the Self Reporting Questionnaire. The explanatory variables were sociodemographic and clinical data of the caregiver. Results: 90 caregivers were evaluated; 83 (92.2%) were female, 51 (56.7%) were married, 60 (66.7%) were sons/daughters and 62 (68.6%) had some occupation besides caring for the demented elderly. The mean age was 57.3 (± 11.7) and the mean educational level was 9.5 (± 4.9) years. Regarding the clinical characteristics of the sample, 62.2% of the caregivers had ≥ 7 on Self Reporting Questionnaire, 50% had anxiety symptoms, 52.2% had depression symptoms and 66.7% burden at some level. Patients with common mental disorder showed higher scores on the Hospital Anxiety and Depression Scale (anxiety and depression) and Zarit Burden Interview scales, with a statistically significant association (p <0.01). There was no statistically significant difference when comparing the two groups in relation to gender, marital status, work and kinship. Logistic regression showed that caregivers with anxiety symptoms were 15 times more likely to present common mental disorder (OR: 15.0; 95% CI: 3.5-71.2) and caregivers with symptoms of depression were 8 times more likely to have common mental disorder (OR: 8.0; 95% CI: 2.1-31.1). Caregivers with burden were 7.2 times more likely to have common mental disorder (OR: 7.2; 95% CI: 1.9-27.2). Younger caregivers were 0.93 times less likely to have common mental disorder (OR: 0.93; 95% CI: 0.88-0.99). Conclusion: The results show that, among the population studied, there was a high prevalence of common mental disorder. We found a significant association of common mental disorder with burden (moderate, moderate/severe and severe) and with anxiety and depression symptoms.
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transtorno mental comum, familiares cuidadores, idosos, demência, sobrecarga, ansiedade, depressão, common mental disorder, family caregivers, elderly, dementia, burden, anxiety, depression