Resumen El objetivo es analizar las asociaciones de victimización y perpetración de bullying con síntomas depresivos y calidad de vida relacionada con la salud (CVRS) en una muestra de adolescentes brasileños de secundaria. Los adolescentes (n=852, 50,2% mujeres, edad media: 16,4 años) respondieron a un cuestionario sobre síntomas depresivos extraído de la Escala de Depresión del Centro de Estudios Epidemiológicos. La CVRS se midió mediante el índice Kidscreen-10 y la información relacionada con el acoso se extrajo de dos preguntas diferentes (víctimas y agresores). Se utilizaron modelos de regresión logística multinivel. Los adolescentes que fueron víctimas de bullying tuvieron mayores niveles de síntomas depresivos y una menor percepción de CVRS que aquellos que no fueron víctimas. Por otro lado, se encontró una relación inversa entre los perpetradores de acoso escolar respecto a aquellos que no lo fueron. El impacto en la salud de los adolescentes varía según su papel en situaciones de bullying.

Resumo O objetivo é analisar as associações da vitimização e perpetração do bullying com sintomas depressivos e qualidade de vida relacionada à saúde (QVRS) em uma amostra de adolescentes brasileiros do ensino médio. Os adolescentes (n=852, 50,2% do sexo feminino, idade média: 16,4 anos) responderam a um questionário sobre sintomas depressivos elaborado a partir da Escala de Depressão do Center for Epidemiologic Studies. A QVRS foi medida através do Índice Kidscreen-10, e a informação relacionada com o bullying foi extraída de duas questões diferentes (vítimas e agressores). Foram utilizados modelos de regressão logística multinível. Os adolescentes vítimas de bullying apresentaram níveis mais altos de sintomas depressivos e uma percepção mais baixa de QVRS do que aqueles que não eram vítimas. Por outro lado, foi encontrada uma relação inversa entre os perpetradores de bullying em comparação com aqueles que não eram perpetradores. O impacto na saúde dos adolescentes varia de acordo com o seu papel em situações de bullying.

Abstract The aim is to analyze the associations of bullying victimization and perpetration with depressive symptoms and health-related quality of life (HRQoL) in a sample of Brazilian high school adolescents. Adolescents (n=852, 50.2% female, mean age: 16.4 years) answered a questionnaire about depressive symptoms drawn from the Center for Epidemiologic Studies Depression Scale. HRQoL was measured using the Kidscreen-10 Index, and bullying-related information was extracted from two different questions (victims and perpetrators). Multilevel logistic regression models were used. Adolescent victims of bullying had higher levels of depressive symptoms and a lower perception of HRQoL than those who were not victims. On the other hand, an inverse relationship was found for perpetrators of bullying compared to those who were not perpetrators. Adolescents’ health-related impacts varied according to their role in bullying situations.

ABSTRACT OBJECTIVE: To explore the associations between current mental health symptoms and social disparities in university students. METHODS: We recruited participants from nine public universities in Brazil, from August to November 2022, using online advertisements and in-person lectures. All participants completed an online survey containing social (sex, race/color, gender identity, sexual orientation, and income) and mental health assessments. The Jeopardy index was composed of social variables. The index considered zero points for subjects with less oppressive experienced characteristics (men, White, cisgender, heterosexual, higher income) and one point for the opposite characteristics. We defined six clusters according to Jeopardy Index results: 0, 1, 2, 3, 4, and 5 points, with the greatest number of points representing the most disadvantaged group. The mental health symptoms were assessed on two levels. First by the “DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure – Adult,” and second by the “Patient Health Questionnaire-9,” and the “Generalized Anxiety Disorder Questionnaire-7.” Adjusted Odds Ratio (OR) analyses was performed for age and educational level. RESULTS: 748 participants were allocated into the six Jeopardy clusters: 0 (n = 46; 6.1%), 1 (n = 112; 15.0%), 2 (n = 163; 21.8%), 3 (n = 218; 29.1%), 4 (n = 171; 22.9%), and 5 (n = 38; 5.1%). It was observed a high prevalence of anxiety (42.5%) and depression (51.0%), however, the less privileged group (5) had a higher risk of having severe symptoms of anxiety (OR = 6.21; 1.51–25.58; p < 0.01) and depression (OR = 8.60; 2.15–34.43; p < 0.01), compared against the most privileged group. CONCLUSION: Although anxiety and depressive symptoms were highly prevalent for all participants, these disorders are not equally distributed in this population and the intersectionality between social factors plays an important role in contributing to these differences.

ABSTRACT Objectives: The objectives of the present study were to assess sedentary behavior and physical activity levels before and during the COVID-19 pandemic in healthy individuals and in those with self-reported diagnosis of anxiety and/or depression, and also identify facilitators and barriers to physical activity in these populations. Methods: This is a cross-sectional survey based on a self-report questionnaire applied during the COVID-19 pandemic period. Results: In the total sample (N = 1,285) the prevalence of sedentary behavior (>8 hours/day) increased by 25% during social isolation. Social isolation increased sedentary time and decreased physical activity levels in healthy individuals and in those with self-reported diagnosis of anxiety and/or depression. In both groups, the most prevalent facilitators were supervised physical activity (before the pandemic) and activities and equipment to practice at home (during the pandemic). The most prevalent barriers were the lack of time to perform physical activities (before the pandemic) and inaccessible or distance places to practice (during the pandemic). Conclusion: The COVID-19 pandemic is related to an increased sedentary behavior and reduced physical activity levels. Significant changes in perceived barriers and facilitators to exercise were observed during the social isolation period.

RESUMO Objetivos: Os objetivos do presente estudo foram avaliar o comportamento sedentário e os níveis de atividade física antes e durante da pandemia de COVID-19 em indivíduos saudáveis e com diagnóstico autorreportado de ansiedade e/ou depressão e identificar os facilitadores e barreiras para a prática de atividade física nessas populações. Métodos: Trata-se de uma pesquisa de corte transversal baseada em um questionário de autorrelato aplicado durante o período de pandemia da COVID-19. Resultados: Na amostra total (N = 1.285), a prevalência de comportamento sedentário (>8 horas/dia) aumentou em 25% durante o isolamento social. O isolamento social aumentou o tempo sedentário e diminuiu os níveis de atividade física em indivíduos saudáveis, com ansiedade e/ou depressão autorreportada. Nos dois grupos, os facilitadores mais prevalentes foram a atividade física supervisionada (antes da pandemia) e as atividades e equipamentos para a prática em casa (durante a pandemia). As barreiras mais prevalentes foram a falta de tempo para realizar atividades físicas (antes da pandemia) e os locais inacessíveis ou distantes para a prática (durante a pandemia). Conclusão: A pandemia de COVID-19 está relacionada a aumento do comportamento sedentário e redução dos níveis de atividade física. Mudanças significativas nas barreiras percebidas e facilitadores ao exercício foram observadas durante o período de isolamento social.

ABSTRACT Objective: Substance misuse can lead to several consequences for physical and mental health. Physical exercise is an important ally to pharmacological and psychotherapeutic treatment for substance use. However, the literature is still scarce regarding long-term interventions. Thus, this study aims to describe the acceptability and effects of combined physical training intervention (aerobic and strength). Methods: This study comprises an n-of-1 clinical trial that was performed with a 64-year-old male individual with alcohol use disorder. The treatment lasted 12 weeks and evaluated the association of multidisciplinary interventions on quality of life, depressive symptoms, cognitive impairment, and anxiety. Results: The participant improved general quality of life (12.5%), no alterations were found for depressive symptoms, there was an improvement in cognition (20%), as well a reduction in the trait (16.2%) and state (14.7%) anxiety symptoms of the participant. Conclusions: These findings allude to the importance of non-drug therapeutic resources such as structured physical exercise, associated with other offers in the treatment of alcohol use disorder.

RESUMO Objetivo: O uso de substâncias psicoativas pode levar a diversas consequências à saúde física e mental. O exercício físico é um importante aliado ao tratamento farmacológico e psicoterápico para o uso de substâncias. No entanto, a literatura ainda é escassa em relação às intervenções de longa duração. Dessa forma, este estudo objetiva descrever a aceitabilidade e os efeitos de uma intervenção de treinamento físico combinado (aeróbico e força). Métodos: Este estudo compreende um n-of-1 clinical trial que foi realizado com um indivíduo do sexo masculino, de 64 anos de idade, com transtorno por uso de álcool. O tratamento teve a duração de 12 semanas e avaliou a associação de intervenções multiprofissionais sobre a qualidade de vida, sintomas depressivos, comprometimento cognitivo e ansiedade. Resultados: O participante melhorou a qualidade de vida geral (12,5%), não foram encontradas alterações para sintomas depressivos, houve melhora na cognição (20%), bem como redução nos sintomas de ansiedade traço (16,2%) e estado (14,7%) do participante. Conclusões: Esses achados aludem à importância de recursos terapêuticos não medicamentosos como o exercício físico estruturado, associados às demais ofertas no tratamento para o transtorno por uso de álcool.

Abstract Introduction Physical activity, conceptualized as any bodily movement that results in energy expenditure, and its structured form, exercise, play an important role in public health, preventing and treating a wide range of physical conditions, including metabolic and cardiovascular diseases and obesity. Objective This article aims to provide a brief overview and summary of the evidence on: 1) the preventive effects of physical activity on a wide range of mental disorders; 2) the role of physical activity in promoting the physical health of people with mental disorders; 3) the role of exercise as a strategy to manage mental health symptoms in a range of mental disorders; and 4) the challenges and barriers faced when implementing exercise in clinical practice. Methods This was a narrative review. Results Compelling evidence has demonstrated that physical activity and exercise can also prevent common mental disorders, such as depression and anxiety disorders, and have multiple beneficial effects on the physical and mental health of people with a wide range of mental disorders. This body of evidence has been incorporated in national and international guidelines over the last decades, which have recommended the inclusion of physical activity and exercise as therapeutic approaches for mental disorders, mainly for depression and schizophrenia. Nonetheless, implementation into clinical practice has been slow, probably due to barriers associated both with patients and mental health professionals. Conclusion Increases in physical activity levels in populations are likely to reduce the mental health burden. Exercise interventions should be incorporated to the routine care of people with mental disorders due its multiple benefits on physical and mental health outcomes. A multidisciplinary approach is needed to overcome patients barriers and enhance adherence and benefits.

Abstract Introduction Individuals with major depressive disorder (MDD) face more barriers to engagement in sports and exercise interventions. Evaluating clinical and demographic factors associated with adherence to sports and exercise among MDD outpatients could support development of new options and strategies to increase their participation. Methods In a cross-sectional study, 268 depressed outpatients were evaluated (83.51% females; mean age = 50.74 [standard deviation {SD} = 10.39]). Sports and exercise participation were assessed using a question about participation frequency during the previous month. Clinical and demographic factors were evaluated. Linear regression was used to identify predictors of participation in sports and exercise. Results MDD patients with mild symptoms of depression (odds ratio [OR] = 2.42; 95% confidence interval [95%CI] 1.00, 5.88; p = 0.04) and patients with mild to moderate symptoms (OR = 3.96; 95%CI 1.41, 11.15; p = 0.009) were more likely to engage regularly in sports and exercise than patients with more severe depression. Moreover, smoking (OR = 0.23; 95%CI 0.67, 0.80; p = 0.007) and being divorced (OR = 0.22; 95%CI 0.57, 0.86; p = 0.03) were associated with lower rates of engagement in sports and exercise. Conclusion Our findings indicate a significant association between clinical and demographic factors and participation in sports and exercise among MDD outpatients.

Resumo Introdução: A depressão maior (DM) é uma doença associada ao estresse crônico que pode apresentar um desequilíbrio nos níveis de cortisol, podendo ser recuperado com a remissão dos sintomas. O exercício tem sido utilizado como uma ferramenta para promover mudanças nos níveis de cortisol em indivíduos saudáveis. No entanto, não se sabe se o exercício produz os mesmos resultados em indivíduos com DM. Objetivo: Revisar evidências de alterações dos níveis de cortisol após o exercício em indivíduos com DM. Métodos: Foi realizada busca nas bases de dados PubMed, SciELO, LILACS, ISI Web of Knowledge, Scopus e PsycInfo. Procedeu-se a metanálise com o cálculo do tamanho do efeito da diferença de média padronizada. Foi utilizado o software Stata v.11.0. Resultados: Foram obtidos na busca 463 estudos. Após o procedimento de seleção, cinco artigos com sete análises foram incluídos. O tipo de exercício, frequência de treinamento, tipo de medida do cortisol e tipo de grupo controle foram analisados como subgrupos. Houve uma redução dos níveis de cortisol no grupo de exercício. Além disso, a análise de sensibilidade e análises de subgrupos revelaram um efeito do tipo (exercício aeróbico) e da frequência (cinco vezes por semana) de exercício na redução dos níveis de cortisol. No entanto, esses resultados devem ser interpretados com cautela, devido ao pequeno número de estudos e uma heterogeneidade substancial entre eles. Conclusão: O exercício promove redução dos níveis de cortisol em indivíduos com DM. No entanto, esse achado pode ser influenciado pelo tipo de exercício, medida do cortisol e frequência semanal.

Abstract Introduction: Major depressive disorder (MDD) is a prevalent medical illness that is associated with chronic stress. Patients with MDD can show an imbalance in cortisol levels, which can be restored with the remission of symptoms. Physical exercise training has been used as a tool to promote changes in cortisol levels in healthy individuals. However, it is unknown if exercise can produce the same results in individuals with MDD. Objective: To review evidence of cortisol changes after exercise training in individuals with MDD. Methods: We conducted a search on PubMed, SciELO, LILACS, ISI Web of Knowledge, Scopus, and PsycInfo databases. Random effects meta-analysis was performed and standardized mean difference (SMD) effect size was calculated. Analyses of forest and funnel plots was conducted using Stata v.11.0 software. Results: At first, 463 studies were obtained in the search. After completion of the selection procedure, five articles with seven analyses were included. Type of exercise, frequency of training, cortisol measurement, and type of control group were analyzed. There was a reduction of cortisol levels in the exercise group (SMD = −0.65, 95%CI 1.30-0.01). Moreover, sensitivity analysis and subgroup analyses revealed an effect of type (aerobic exercise) and frequency (five times per week) of exercise on reduction of cortisol levels. However, these results should be interpreted cautiously due to the small number of studies and a substantial heterogeneity among them. Conclusion: Physical exercise promotes a reduction in cortisol levels in individuals with MDD. However, this finding can be influenced by type of exercise, weekly frequency, and type of cortisol measurement.

O objetivo do presente estudo foi de avaliar os efeitos do treinamento de força, com prescrição baseada na percepção de esforço, nos sintomas depressivos e na Qualidade de Vida Relacionada à Saúde (QVRS) de idosas. Participaram do estudo 24 idosas (idade de 65,6 ± 4,5 anos), submetidas a um treinamento de força duas vezes por semana, durante 12 semanas com intensidade prescrita através da escala de percepção de esforço de BORG. Utilizou-se a escala de depressão geriátrica (EDG) de para rastreio de depressão e avaliação dos sintomas depressivos. Para avaliação da QVRS, utilizou-se o Questionário de Qualidade de Vida Short Form-36 (SF-36). Para comparação das variáveis pré e pós-treinamento foi utilizado o teste de Wilcoxon. Foi encontrada uma redução dos sintomas depressivos, bem como da frequência de idosas com pontuação indicativa de episódio depressivo atual, após o treinamento de força. Para a QVRS, foram encontradas melhoras nas subescalas de capacidade funcional, estado geral da saúde, vitalidade e saúde mental. O treinamento de força, baseado na percepção de esforço, foi um método efetivo para uma redução nos sintomas de depressivos das participantes bem como para melhora da QVRS relacionada à saúde nas seguintes subescalas do SF-36: vitalidade, capacidade funcional, estado geral da saúde e saúde mental em idosas.

The objective of this study was to evaluate the effects of strength training, based on the perceived effort, on depressive symptoms and Health-Related Quality of Life (HRQoL) of elderly women. Twenty four older women (65.6 ± 4.5 years), performed training exercise two times per week during 12 weeks. The intensity was prescribed using the BORG perceived effort scale. The Geriatric Depression Scale (EDG) was used to evaluate the depressive symptoms intensity. The HRQoL, was evaluated thought the Short Form-36 (SF-36). A significant decrease of depressive symptoms was found. The HRQoL improved in some, but not all subscales. Improvements were found at functional capacity, general heath, vitality and mental health subscales. The strength training, based on perceived effort, was an effective method to decrease the depressive symptoms and improve HRQoL on the functional capacity, general heath, vitality and mental health subscales of SF-36 on older women.