A fim de determinar a prevalência de transtornos mentais em uma amostra de pacientes de um hospital geral e sua relação com a denominação religiosa e religiosidade, foram investigados 253 pacientes internados no Hospital das Clínicas da Universidade Estadual de Campinas por intermédio de um questionário sócio-demográfico e um instrumento para diagnóstico psiquiátrico (MINI-Plus). A maioria dos pacientes era católica (63,2%; n = 177); seguidos dos evangélicos pentecostais (20,4%; n = 57); dos "sem-religião" (7,5%; n = 21); espíritas (4,3%; n = 12) e protestantes históricos (2,3%; n = 8). Consideraram-se muito religiosos 43,2% (n = 116), religiosos 46,9% (n = 129), pouco religiosos 9,8% (n = 27), não religiosos 1,1% (n = 3). A filiação religiosa evangélica e maior freqüência a cultos relacionaram-se à menor freqüência de problemas com álcool. É possível que a filiação religiosa evangélica exerça uma ação inibidora na ocorrência de transtornos relacionados ao álcool. Indivíduos muito religiosos ou pouco/nada religiosos apresentaram maior prevalência de transtorno bipolar. A dimensão intensidade da religiosidade revelou-se modestamente associada à prevalência geral dos transtornos, especialmente ao transtorno bipolar. É razoável que situações extremas (de muito ou reduzido envolvimento) relacionem-se a tal achado, relacionando tanto a busca exacerbada ou o afastamento da religiosidade com estados mentais alterados.

In order to evaluate the prevalence of psychiatric disorders in a Brazilian general hospital and their association with religious denomination and religiosity, 253 inpatients were interviewed. A socio-demographic questionnaire and an instrument for diagnosis of mental disorders (MINI-Plus) were applied. Distribution of religious denominations was: Catholic 63.2% (n = 177), Evangelical Protestant 20.4% (n = 57), Spiritist 4.3% (n = 12), traditional Protestant 2.3% (n = 8), and "no religion" 7.5% (n = 21). Degree of religiosity was: very religious 43.2% (n = 116), religious 46.9% (n = 129), hardly religious 9.8% (n = 27), and not at all religious 1.1% (n = 3). Evangelical (Pentecostal) religious affiliation and frequent attendance at worship services were associated with fewer alcohol problems. Membership in an Evangelical (Pentecostal) church may thus have an inhibitory effect on alcohol dependence or abuse. Intensity of religiosity was moderately associated with overall prevalence of disorders, especially bipolar disorder. It is reasonable to conclude that extreme situations (very intense versus very limited religious participation) are related to this finding, associating both an exacerbated pursuit of religion and alienation from it with altered mental states.

A fim de determinar a prevalência de transtornos mentais em uma amostra de pacientes de um hospital geral e sua relação com a denominação religiosa e religiosidade, foram investigados 253 pacientes internados no Hospital das Clínicas da Universidade Estadual de Campinas por intermédio de um questionário sócio-demográfico e um instrumento para diagnóstico psiquiátrico (MINI-Plus). A maioria dos pacientes era católica (63,2%; n = 177); seguidos dos evangélicos pentecostais (20,4%; n = 57); dos "sem-religião" (7,5%; n = 21); espíritas (4,3%; n = 12) e protestantes históricos (2,3%; n = 8). Consideraram-se muito religiosos 43,2% (n = 116), religiosos 46,9% (n = 129), pouco religiosos 9,8% (n = 27), não religiosos 1,1% (n = 3). A filiação religiosa evangélica e maior freqüência a cultos relacionaram-se à menor freqüência de problemas com álcool. É possível que a filiação religiosa evangélica exerça uma ação inibidora na ocorrência de transtornos relacionados ao álcool. Indivíduos muito religiosos ou pouco/nada religiosos apresentaram maior prevalência de transtorno bipolar. A dimensão intensidade da religiosidade revelou-se modestamente associada à prevalência geral dos transtornos, especialmente ao transtorno bipolar. É razoável que situações extremas (de muito ou reduzido envolvimento) relacionem-se a tal achado, relacionando tanto a busca exacerbada ou o afastamento da religiosidade com estados mentais alterados.

In order to evaluate the prevalence of psychiatric disorders in a Brazilian general hospital and their association with religious denomination and religiosity, 253 inpatients were interviewed. A socio-demographic questionnaire and an instrument for diagnosis of mental disorders (MINI-Plus) were applied. Distribution of religious denominations was: Catholic 63.2% (n = 177), Evangelical Protestant 20.4% (n = 57), Spiritist 4.3% (n = 12), traditional Protestant 2.3% (n = 8), and "no religion" 7.5% (n = 21). Degree of religiosity was: very religious 43.2% (n = 116), religious 46.9% (n = 129), hardly religious 9.8% (n = 27), and not at all religious 1.1% (n = 3). Evangelical (Pentecostal) religious affiliation and frequent attendance at worship services were associated with fewer alcohol problems. Membership in an Evangelical (Pentecostal) church may thus have an inhibitory effect on alcohol dependence or abuse. Intensity of religiosity was moderately associated with overall prevalence of disorders, especially bipolar disorder. It is reasonable to conclude that extreme situations (very intense versus very limited religious participation) are related to this finding, associating both an exacerbated pursuit of religion and alienation from it with altered mental states.

OBJECTIVE: To evaluate the concurrent validity, internal consistency and responsiveness of King's Health Questionnaire (KHQ) in patients who underwent sling procedures for the treatment of stress urinary incontinence. MATERIALS AND METHODS: We performed a prospective open label multicenter study in 4 tertiary referral centers. Sixty-eight female patients were enrolled with urodynamically diagnosed urinary stress incontinence. Patients were treated using surgical procedures, mostly (73%) with the synthetic sling procedure, which has been considered one of the gold standard methods for the treatment of urinary incontinence. The patients were assessed before and after one month of postoperative follow up, using the KHQ in its validated Portuguese version. Patients also underwent preoperative urodynamic test, Stamey incontinence grading, pad usage and the assessment of number of pads used per day. After surgery, patients underwent stress test, Stamey incontinence grading pad usage and the assessment of number of pads used per day. RESULTS: The concurrent validity showed good correlations in some domains of KHQ to clinical parameters. The internal consistency was higher after treatment compared to preoperative values. Objective parameters, such as pad usage and the assessment of number of pads used per day, had significant correlation with changes in post-treatment scores on KHQ. The responsiveness expressed in terms of standardized effect size (SES) and standardized response mean (SRM) was large. CONCLUSION: The results showed moderate concurrent validity, strong internal consistency and high responsiveness for KHQ, indicating that it is suitable for measuring outcomes in clinical trials among female patients with stress urinary incontinence.

Para estimar a prevalência de transtornos do humor, foram utilizadas a entrevista estruturada, "Clinical Interview Schedule" (CIS-R), e a escala "Hospital Anxiety and Depression" (HAD) em 78 pacientes internados em uma enfermaria geral de adultos (43 homens e 35 mulheres, média de idade = 43,2 anos). Foi encontrada prevalência instantânea de 39% de transtornos do humor. Dezesseis (20,5%) pacientes preencheram critérios para ansiedade, a maioria dos casos sendo de gravidade leve. Vinte e seis (33%) casos de depressão foram detectados, 7 dos quais de gravidade moderada. Observou-se uma combinação de sintomas de preocupação, depressão, ansiedade e insônia. A HAD mostrou-se de fácil compreensão pelos pacientes. As subescalas de ansiedade e de depressão tiveram consistência interna de 0,68 e 0,77, respectivamente. A correlação dos itens com as respectivas subescalas sugere que essas possuem validades convergentes, não discriminantes. Com ponto de corte 8/9, a sensibilidade e a especificidade foram 93,7% e 72,6%, para ansiedade, e 84,6% e 90,3%, para depressão. Na prática clínica, a utilização da HAD poderia auxiliar na detecção de casos de transtornos do humor que necessitam de tratamento.

The revised Clinical Interview Schedule (CIS-R) and the Hospital Anxiety and Depression (HAD) Scale were used to estimate the prevalence of mood disorders among 78 consecutive admissions to a general medical ward in a university general hospital in Brazil (43 males and 35 females; mean age = 43.2yr). Interviewers also completed a 5-point symptom severity scales for anxiety and depression. The definition of cases of anxiety [and depression] was based on two criteria: a. score > 2 on the CIS-R section of anxiety [> 4 on the CIS-R sections of depression and depressive ideas]; and b. score > 2 on the clinical severity scale for anxiety [score > 2 on the clinical severity scale for depression]. A 39% prevalence rate of affective disorders was found. Sixteen (20.5%) patients met criteria for anxiety, most of the disorders being of mild severity. Twenty-sic patients (33%) were depressed, 7 of them in a moderate degree. The HAD was easily understood by the patients. Anxiety and depression subscales had internal consistency of 0.68 and 0.77, respectively. At a cut-off point of 8/9 sensibility and specificity were 93.7% and 72.6% for anxiety, and 84.6% and 90.3% for depression. HAD items correlated positively with the respective subscales. To a lesser degree, they also correlated with the alternative subscale. Our findings confirm the high prevalence of mood disorders among medical in-patients. In clinical practice, the HAD may have a useful role in detecting those patients requiring further psychological care.

Para estimar a prevalência de transtornos do humor, foram utilizadas a entrevista estruturada, "Clinical Interview Schedule" (CIS-R), e a escala "Hospital Anxiety and Depression" (HAD) em 78 pacientes internados em uma enfermaria geral de adultos (43 homens e 35 mulheres, média de idade = 43,2 anos). Foi encontrada prevalência instantânea de 39% de transtornos do humor. Dezesseis (20,5%) pacientes preencheram critérios para ansiedade, a maioria dos casos sendo de gravidade leve. Vinte e seis (33%) casos de depressão foram detectados, 7 dos quais de gravidade moderada. Observou-se uma combinação de sintomas de preocupação, depressão, ansiedade e insônia. A HAD mostrou-se de fácil compreensão pelos pacientes. As subescalas de ansiedade e de depressão tiveram consistência interna de 0,68 e 0,77, respectivamente. A correlação dos itens com as respectivas subescalas sugere que essas possuem validades convergentes, não discriminantes. Com ponto de corte 8/9, a sensibilidade e a especificidade foram 93,7% e 72,6%, para ansiedade, e 84,6% e 90,3%, para depressão. Na prática clínica, a utilização da HAD poderia auxiliar na detecção de casos de transtornos do humor que necessitam de tratamento.

The revised Clinical Interview Schedule (CIS-R) and the Hospital Anxiety and Depression (HAD) Scale were used to estimate the prevalence of mood disorders among 78 consecutive admissions to a general medical ward in a university general hospital in Brazil (43 males and 35 females; mean age = 43.2yr). Interviewers also completed a 5-point symptom severity scales for anxiety and depression. The definition of cases of anxiety [and depression] was based on two criteria: a. score > 2 on the CIS-R section of anxiety [> 4 on the CIS-R sections of depression and depressive ideas]; and b. score > 2 on the clinical severity scale for anxiety [score > 2 on the clinical severity scale for depression]. A 39% prevalence rate of affective disorders was found. Sixteen (20.5%) patients met criteria for anxiety, most of the disorders being of mild severity. Twenty-sic patients (33%) were depressed, 7 of them in a moderate degree. The HAD was easily understood by the patients. Anxiety and depression subscales had internal consistency of 0.68 and 0.77, respectively. At a cut-off point of 8/9 sensibility and specificity were 93.7% and 72.6% for anxiety, and 84.6% and 90.3% for depression. HAD items correlated positively with the respective subscales. To a lesser degree, they also correlated with the alternative subscale. Our findings confirm the high prevalence of mood disorders among medical in-patients. In clinical practice, the HAD may have a useful role in detecting those patients requiring further psychological care.