Um Modelo Preditivo Preliminar da Sintomatologia Depressiva nas Doen?as Neurodegenerativas: o papel da dor neurop?tica, fadiga, incapacidade e processos de regula??o emocional

• Autor(a) principal: Ferreira, Cristiana Sofia Neto
• Data de Publicação: 2022
• Outros Autores: Carvalho, Teresa (Orientadora)
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://repositorio.ismt.pt/jspui/handle/123456789/1419
• topic: Doen?as neurodegenerativas - Neurodegenerative diseases; Modelo preditivo da depress?o - Predictive model of depression; Modelo de incapacidade - Disability model; Evitamento experiencial - Experiential avoidance; Vida comprometida - Committed living

Introdu??o: As doen?as neurodegenerativas (DNs) s?o patologias cr?nicas, incapacitantes e com preval?ncia consider?vel. A doen?a de Parkinson, Esclerose M?ltipla e a Esclerose Lateral Amiotr?fica, destacam-se, devido ? sua preval?ncia e impacto negativo. Particularmente, tendem a concorrer com a depress?o. No entanto, ? insuficiente o conhecimento cientifico sobre os preditores de depress?o em doentes com DNs. Objetivos: O estudo teve como principal objetivo analisar se a dor neurop?tica, fadiga, incapacidade geral, o evitamento experiencial, fus?o cognitiva e a vida comprometida predizem conjuntamente os sintomas psicopatol?gicos de depress?o em pessoas com DNs. M?todo: Integraram neste estudo transversal duas amostras de conveni?ncia: 93 participantes com diagn?stico de DNs e 198 indiv?duos sem DNs. Os dois grupos, sem outras doen?as neurol?gicas. Foram administrados os seguintes question?rios: Six Item Cognitive Impairment Test, Question?rio Sociodemogr?fico e Cl?nico para Doentes com Doen?as Neurodegenerativas, subescala de depress?o da Depression, Anxiety and Stress Scales, Escala Anal?gica Visual do Pain Detect Questionnaire, Escala Anal?gica Visual da Fadiga, World Health Organization Disability Assessment Schedule, Acceptance and Action Questionnaire - II, Cognitive Fusion Questionnaire e Engaged Living Scale. Resultados: As amostras exibiram diferen?as estatisticamente significativas para todos os potenciais preditores, excepto a fus?o cognitiva e, por isso n?o avan?ou para a etapa seguinte. No grupo com DNs, os restantes potenciais preditores correlacionaram-se com os sintomas de depress?o e predisseram significativamente estes sintomas em modelos RLS. O modelo RLM explicou uma percentagem da vari?ncia (47%) dos sintomas de depress?o no grupo cl?nico. A incapacidade geral e o evitamento experiencial, com valores de betas negativos e a vida comprometida, com um valor de beta positivo, predisseram significativamente a mencionada sintomatologia. Discuss?o: A incapacidade geral e o evitamento experiencial mostraram ser fatores de risco para a depress?o em doentes com DNs, enquanto a vida comprometida revelou ser um fator protetor da presen?a de tais sintomas. Sugere-se o apoio psicol?gico com a finalidade de prevenir a depress?o em pessoas com DNs e utilize-se modelos de interven??o que minimizem o impacto da incapacidade no humor depressivo dos doentes e promovam a aceita??o das suas experi?ncias dolorosas, bem como a??es congruentes com os valores pessoais. / Introduction: Neurodegenerative diseases (NDs) are chronic, disabling pathologies with considerable prevalence. Parkinson's disease, Multiple Sclerosis and Amyotrophic Lateral Sclerosis stand out due to their prevalence and negative impact. In particular, they tend to co-occur with depression. However, there is insufficient scientific knowledge about the predictors of depression in patients with NDs. Objectives: The study's main objective was to examine whether neuropathic pain, fatigue, general disability, experiential avoidance, cognitive fusion, and impaired living jointly predict psychopathological symptoms of depression in people with NDs. Method: Two convenience samples were included in this cross-sectional study: 93 participants diagnosed with NDs and 198 individuals without NDs. Both groups without other neurological diseases. The following questionnaires were administered: Six Item Cognitive Impairment Test, Sociodemographic and Clinical Questionnaire for Patients with Neurodegenerative Diseases, depression subscale of the Depression, Anxiety and Stress Scales, Visual Analog Scale of the Pain Detect Questionnaire, Visual Analog Scale of Fatigue, World Health Organization Disability Assessment Schedule, Acceptance and Action Questionnaire - II, Cognitive Fusion Questionnaire and Engaged Living Scale. Results: The samples exhibited statistically significant differences for all potential predictors except cognitive fusion and therefore did not advance to the next step. In the group with NDs, the remaining potential predictors correlated with depression symptoms and significantly predicted these symptoms in RLS models. The RLM model explained a percentage of the variance (47%) of depression symptoms in the clinical group. General disability and experiential avoidance, with negative betas values, and compromised life, with a positive beta value, significantly predicted the mentioned symptomatology. Discussion: General disability and experiential avoidance have been shown to be risk factors for depression in patients with NDs, while impaired living proved to be a protective factor for the presence of such symptoms. Psychological support is suggested in order to prevent depression in people with NDs and use intervention models that minimize the impact of disability on patients' depressive mood and promote acceptance of their painful experiences, as well as actions congruent with personal values.