Cuadros de ansiedad y depresión: estudio de factores psicoafectivos, familiares y cotidianos en indivíduos celíacos

Guedes, Nirla Gomes; Silva, Leonardo Alexandrino da; Bessa, Cristina Costa; Santos, Jorgiana Cavalcanti dos; Silva, Viviane Martins da; Lopes, Marcos Venícios de Oliveira

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (Suppl 1) • 2020 • https://doi.org/10.1590/0034-7167-2020-0086 copiar

Cuadros de ansiedad y depresión: estudio de factores psicoafectivos, familiares y cotidianos en indivíduos celíacos

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Identificar la prevalencia de ansiedad y depresión y la asociación con variables psicoafectivas, familiares y cotidianas en celíacos.

Métodos:

Estudio transversal, desarrollado con 83 celíacos, en Fortaleza. Se aplicó instrumento con variables agrupadas en las categorías de factores: psicoafectivos, familiares y cotidianos.

Resultados:

La ansiedad ha sido identificada en 52 celíacos (62,7%); y la depresión, en 29 (34,9%). Condición clínica percibida y Cantidad de síntomas aumentan la ocasión para ansiedad/depresión. Descontrol de la enfermedad celíaca (98,1%), Condición clínica percibida (75,0%), Obstáculos diarios para dieta sin gluten (63,4%) y Actividades cotidianas (55,8%) han sido los factores más predominantes en aquellos con ansiedad. En la presencia de depresión, hubo mayor prevalencia de Descontrol de la enfermedad celíaca (100,0%), Condición clínica percibida (82,8%) y Obstáculos diarios para dieta sin gluten (69,0%).

Conclusión:

Celíacos con cuadros de ansiedad y depresión presentaron mayor frecuencia de Condición clínica percibida y Apoyo social insuficiente (factores psicoafectivos) y Obstáculos diarios para dieta sin gluten (factor cotidiano).

Descriptores:
Enfermedad Celíaca; Enfermedad Crónica; Dieta sin Gluten; Depresión; Ansiedad

Variables				n	%
1. Psychoaffective factors
Lack of knowledge about the pathology
No				83	100
Yes				0	0
Perceived clinical condition
No				24	28.9
Yes				59	71.1
Insufficient social support
No				68	81.9
Yes				15	18.1
2. Family-related factors
Unsatisfactory shared care
No				81	97.6
Yes				2	2.4
Family support
No				40	48.2
Yes				43	51.8
3. Daily-life factors
Lack of control of the celiac disease
No				4	4.8
Yes				79	95.2
Daily activities
No				36	43.4
Yes				47	56.6
Daily obstacles in the maintenance of the GFD
No				37	44.6
Yes				46	55.4
4. Anxiety
No				31	37.3
Yes				52	62.7
5. Depression
No				54	65.1
Yes				29	34.9
	Medium	SD	Median	IIQ	p *value^ * Kolmogorov-Smirnov's test.**
6. Social support (affective)	4.80	0.598	5.0	0.0	0.000
7. Social support (positive social interaction)	4.49	0.806	5.0	0.7	0.000
8. Social support (emotional)	4.21	0.968	4.7	1.5	0.000
9. Total anxiety score	14.62	9.831	14.0	12.0	0.082
10. Total depression score	9.84	6.80	10.0	9.0	0.033

Mean of the variable results	Anxiety scores	Depression scores	p value^* * Mann-Whitney's test;
1. Lack of knowledge about the pathology
Absent	19.88	20.63	^† † No statistic could be calculated; CD: Celiac Disease; GFD: Gluten-free diet.
Present	43.12	43.08
2. Perceived clinical condition
Absent	37.00	31.15	0.228
Present	44.03	46.42	0.009
3. Insufficient social support
Absent	41.25	39.56	0.546
Present	45.40	53.07	0.049
4. Unsatisfactory shared care
Absent	42.46	41.98	0.271
Present	23.50	42.75	0.964
5. Family support
Absent	47.18	45.69	0.059
Present	37.19	38.57	0.178
6. Lack of control of the CD
Absent	19.88	20.63	0.060
Present	43.12	43.08	0.069
7. Daily activities
Absent	41.03	43.14	0.748
Present	42.74	41.13	0.706
8. Daily obstacles in the maintenance of the GFD
Absent	38.42	34.07	0.224
Present	44.88	48.38	0.007

Variables	Anxiety				Statistics
	Ausente		Presente
	n	%	n	%
1. Lack of knowledge about the pathology
Absent	31	100	52	100
Present	0	0	0	0	^* * No statistic could be calculated.
Total	31	100.0	52	100.0
2. Perceived clinical condition
Absent	11	35.5	13	25	p = 0.308^† † Chi-squared test.
Present	20	64.5	39	75	OR = 1.650
Total	31	100.0	52	100.0	IC 95%: 0.627-4.340
3. Insufficient social support
Absent	27	87.1	41	78.9	p = 0.345^† † Chi-squared test.
Present	4	12.9	11	21.1	OR = 1.811
Total	31	100.0	52	100.0	IC 95%: 0.522-6.278
4. Unsatisfactory shared care
Absent	30	96.8	51	98.1	p = 1.00^‡ ‡ Fisher's exact test.
Present	1	3.2	1	1.9	OR = 0.588
Total	31	100.0	52	100.0	IC 95%: 0.035-9.753
5. Family support
Absent	11	35.5	29	55.8	p = 0.351^† † Chi-squared test.
Present	20	64.5	23	44.2	OR = 0.650
Total	31	100.0	52	100.0	IC 95%: 0.262-1.611
6. Lack of control of the CD
Absent	3	9.7	1	1.9	p = 0.144^‡ ‡ Fisher's exact test.
Present	28	90.3	51	98.1	OR = 5.464
Total	31	100.0	52	100.0	IC 95%: 0.543-55.03
7. Daily activities
Absent	13	41.9	23	44.2	p = 0.838^† † Chi-squared test. OR = 0.911
Present	18	58.1	29	55.8
Total	31	100.0	52	100.0	IC 95%: 0.371-2.238
8. Daily obstacles in the maintenance of the GFD
Absent	18	58.1	19	36.5	p = 0.056^† † Chi-squared test.
Present	13	41.9	33	63.4	OR = 2.405
Total	31	100.0	52	100.0	IC 95%: 0.968-5.972

Variables	Depression				Statistics
	Absent		Present
	n	%	n	%
1. Lack of knowledge about the pathology
Absent	54	100.0	29	100.0	^* * No statistic could be calculated.
Present	0	0.0	0	0.0
Total	54	100.0	29	100.0
2. Perceived clinical condition
Absent	19	35.2	5	17.2	p = 0.086^† † Chi-squared test.
Present	35	64.8	24	82.8	OR = 2.606
Total	54	100.0	29	100.0	IC 95%: 0.856-7.936
3. Insufficient social support
Absent	47	87.0	21	72.4	p = 0.099^† † Chi-squared test.
Present	7	13.0	8	27.6	OR = 2.558
Total	54	100.0	29	100.0	IC 95%: 0.820-7.977
4. Unsatisfactory shared care
Absent	53	98.1	28	96.5	p = 1.000^‡ ‡ Fisher's exact test.
Present	1	1.9	1	3.5	OR = 1.893
Total	54	100.0	29	100.0	IC 95%: 0.114-31.421
5. Family support
Absent	24	44.4	16	55.2	p = 0.351^† † Chi-squared test.
Present	30	55.6	13	44.8	OR = 0.650
Total	54	100.0	29	100.0	IC 95%: 0.262-1.611
6. Lack of control of the CD
Absent	4	7.4	0	0.0
Present	50	92.6	29	100.0	p = 0.292^‡ ‡ Fisher's exact test.
Total	54	100.0	29	100.0
7. Daily activities
Absent	21	38.9	15	51.7	p = 0.261^† † Chi-squared test.
Present	33	61.1	14	48.3	OR = 0.594
Total	54	100.0	29	100.0	IC 95%: 0.239-1.477
8. Daily obstacles in the maintenance of the GFD
Absent	28	51.9	9	31.0	p = 0.069^† † Chi-squared test.
Present	26	48.1	20	69.0	OR = 2.393
Total	54	100.0	29	100.0	IC 95%: 0.925-6.192

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[1] Corresponding author: Leonardo Alexandrino da Silva E-mail: alexandeinoleo@hotmail.com