Abstract Background With the growth of the elderly population in Brazil and the increasing impact of depression and anxiety, the importance of preventing these disorders has been highlighted. Studies have shown an inverse relationship between rates of depression/anxiety and physical activity, pointing out its role as a possible protective factor. Objectives To conduct a randomized study with elderly adults in the community, who present with subsyndromal depression and anxiety, that will evaluate the effectiveness of physical activity with a collaborative stepped-care strategy; and to compare the effectiveness of physical activity in preventing subsyndromal depression and anxiety, with regard to the usual care group. Methods The article contains the methodological description of an arm of a large study entitled “Prevention and Treatment of Depression in Elderly”, in which 2,566 Brazilian older adults were screened to identify clinically significant depressive and anxiety symptoms. Those with clinically significant depressive or anxiety symptoms, not meeting criteria for depressive or anxiety disorder, will be invited to participate in a randomized clinical trial with 2 intervention groups: a step-by-step preventive care programme using physical activity, and usual care. The effectiveness of physical activity in the prevention of depressive and anxiety disorders will be evaluated. Discussion New health policies could be implemented, aiming to reduce the number of elderly people with depression and anxiety in primary care. In addition, training may be implemented for family health teams so that screening tools could be used to make an early identification of individuals with (or at risk of developing) mental disorders.

OBJECTIVES: To examine the association of life events and social support in the broadly defined category of depression in late life. INTRODUCTION: Negative life events and lack of social support are associated with depression in the elderly. Currently, there are limited studies examining the association between life events, social support and late-life depression in Brazil. METHODS: We estimated the frequency of late-life depression within a household community sample of 367 subjects aged 60 years or greater with associated factors. ''Old age symptomatic depression'' was defined using the Composite International Diagnostic Interview 1.1 tool. This diagnostic category included only late-life symptoms and consisted of the diagnoses of depression and dysthymia as well as a subsyndromal definition of depression, termed ''late subthreshold depression''. Social support and life events were assessed using the Comprehensive Assessment and Referral Evaluation (SHORT-CARE) inventory. RESULTS: ''Old age symptomatic depression'' occurred in 18.8% of the patients in the tested sample. In univariate analyses, this condition was associated with female gender, lifetime anxiety disorder and living alone. In multivariate models, ''old age symptomatic depression'' was associated with a perceived lack of social support in men and life events in women. DISCUSSION: Social support and life events were determined to be associated with late-life depression, but it is important to keep in mind the differences between genders. Also, further exploration of the role of lifetime anxiety disorder in late-life depression may be of future importance. CONCLUSIONS: We believe that this study helps to provide insight into the role of psychosocial factors in late-life depression.

Objetivo: Objetivou-se avaliar a presença de ideação suicida, sintomas depressivos e sintomas de desesperança entre três cursos da área da saúde. Método: A população do estudo consistiu de todos os estudantes de medicina matriculados na Faculdade de Medicina da Fundação do ABC, Brasil, durante 2006 e 2007, comparados com os alunos matriculados nos cursos de enfermagem e farmácia. Aplicamos a Escala de Ideação Suicida de Beck, o Inventário de Depressão de Beck e a Escala de Desesperança de Beck para avaliar sintomatologia psiquiátrica. A taxa de resposta entre os estudantes de medicina, enfermagem e farmácia foi de 56%, 56% e 61%, respectivamente. Resultados: Não houve diferença em relação à presença de ideação suicida entre os estudantes de medicina, enfermagem e farmácia. Também não houve diferença em relação à presença de depressão ou desesperança nos estudantes de medicina em comparação com os alunos de enfermagem e farmácia. Taxas de gravidade significativamente mais elevadas foram observadas apenas em desesperança entre os estudantes de medicina em comparação com os alunos de enfermagem e farmácia. Conclusão: Embora não tenhamos observado diferenças significativas entre os três cursos da área da saúde com relação à ideação suicida e depressão, a presença de ideação suicida é um achado preocupante. A identificação precoce destes sintomas é fundamental, de modo a se oferecer apoio e tratamento adequados e prevenir mortes por suicídio.

Objective: We aimed to assess the presence of suicidal ideation, depressive symptoms and symptoms of hopelessness in three healthcare training programs. Method: The study's population comprised all students enrolled at the Medical School of the Fundação do ABC, Brazil, from 2006 to 2007 compared to students enrolled in nursing and pharmacy programs. We applied the Beck Scale for Suicidal Ideation, the Beck Depression Inventory and the Beck Hopeless Scale to assess psychiatric symptomatology. The general response rates of the medical, nursing, and pharmacy students were 56%, 56% and 61%, respectively. Results: There was no difference regarding the presence of suicidal ideation among medical, nursing and pharmacy students. There was also no difference regarding the presence of either depression or hopelessness in medical students in comparison to nursing and pharmacy students. In comparison to nursing and pharmacy students, significantly higher severity rates in terms of hopelessness were observed only among medical students. Conclusion: Although we did not observe significant differences regarding suicidal ideation and depression among the three healthcare programs, our findings suggest that the presence of suicidal ideation is indeed a source of concern. Early identification of these symptoms is crucial in order to offer appropriate support and treatment and prevent deaths by suicide.