Resumo
Objetivo: Examinar o fenômeno da comorbilidade de sintomas de ansiedade e depressão em crianças. Metodologia: Revisão dos artigos disponíveis na base de dados PsycINFO e na base de dados da Universidade Autônoma de Barcelona utilizando como palavras chave: sintomas de ansiedade, síntomas depressivos e comorbilidade. Resultados: Os sintomas de ansiedade e de depressão tem uma alta prevalência na infância. Alguns meninos e meninas, sem cumprir todos os critérios para diagnosticar um transtorno, apresentam sintomas que alteram o funcionamento escolar, social e/ou familiar. Frequentemente estes dois grupos de sintomas se encontram comorbidos num mesmo individuo, produzindo dificuldades no processo de tratamento. Aproximadamente, desde há vinte anos, se tem realizado estudos sobre o fenômeno da comorbilidade entre transtornos psicológicos, tais como ansiedade e depressão. Os resultados destes trabalhos avaliam a possibilidade de que exista um novo transtorno misto ansiedade/depressão com piores consequências para a saúde. Este fato abre novas diretrizes de pesquisa sobre o estudo de transtornos e sintomas na infância, as quais ampliarão neste trabalho.
Referências
Diler R, Birmaher B, Brent D, Axelson D, Firinciogullari S, Chiapetta L et al. Phenomenology of Panic Disorder in Youth. Depression and Anxiety 2004; 20: 39-43.
Angold A, Costello EJ, Erkanli A. Comorbidity. Journal of child psychology and psychiatry 1999; 40(1): 57-87.
Bernstein G, Brochardt C, Perwien A. Anxiety disorders in Children and Adolescents: a review of the past 10 years. Journal of American academy of child and adolescent Psychiatry 1996; 35(9): 1110-1119. [Artículo especial].
Cabasés SS. Trastornos por ansiedad en la infancia y adolescencia. En: Ballesteros MC, coordinador. Práctica clínica paidopsiquiátrica: historia clínica, guías clínicas. Madrid: Adalia; 2006. p. 150-163.
Ruiz MJ, Gómez-Ferrer C. Trastornos depresivos en el niño y adolescente. En: Ballesteros MC, coordinador. Práctica clínica paidopsiquiátrica: historia clínica, guías clínicas. Madrid: Adalia; 2006. p. 203-209.
Axelson D, Birmaher B. Relation between anxiety and depressive disorders in childhood and adolescence. Depression and Anxiety 2001; 14: 67-78.
Silverman W, Ollendick T. Evidence-based assessment of anxiety and its disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology 2005; 34(3): 380-411.
Romero K, Canals J, Hernández-Martínez C, Jané MC, Viñas F, Domènech-Llaberia E. Comorbilidad entre los factores del SCARED y la sintomatología depresiva en niños de 8-12 años. Psicothema 2010; 22: 613-618.
Taboada J, Ezpeleta A, de la Osa N. Trastornos por ansiedad en la infancia y adolescencia: Factores de Riesgo. Ansiedad y Estrés 1998; 4(1): 1-16.
Lapouse R, Monk MA. An epidemiological study of behaviour characteristics in children. American Journal of Public Health 1958; 48: 1134-1144.
Echeburúa E, Corral P. Trastornos de ansiedad en la infancia y adolescencia. Madrid: edición Pirámide; 2003.
Cartwright-Hatton S, McNicol K, Doubleday E. Anxiety in a neglected population: Prevalence of anxiety disorders in pre-adolescent children. Clinical Psychology Review, 26(7). Special issue: Anxiety of Childhood and adolescent: Challenges and opportunities 2006; 817-833.
Boyd CP, Kostanski M, Gullone E, Ollendick TH, Shek DT. Prevalence of anxiety and depression in australian adolescents: Comparisons with worldwide data. Journal of Genetic Psychology 2000; 161(4): 479-492.
Spielberger CD. Manual for the state-trait inventory for children. Palo Alto, C.A: Consulting Psychologists Press; 1973.
Reynolds C, Richmond B. Revised children’s manifest anxierty scale: Manual. Los Angeles: Western Psychological Services; 1985.
March J, Parker J, Sullivan K, Stalling P, Conners C. The Multidimensional Anxiety Scale for Children: Factor structure, reliability, and validity. Journal of the American Academy of Child Adolescent Psychiatry 1997; 36: 554 -565.
Spence S. Structure of anxiety symptoms among children: A confirmatory factor-analytic study. Journal of abnormal psychology 1998; 106: 280-297.
Birmaher B, Brent D, Chiapetta L, Bridge J, Monga S, Baugher M. Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A replication study. Journal of the American Academy of Child and Adolescent Psychiatry 1999; 38(10): 1230-1236.
Birmaher B, Khetarpal S, Cully M. The Screen for child Anxiety Related Emotional Disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry 1997; 36 (4): 545-553.
Descuret F. La médecine des passions, ou les passions considérées dans leurs rapports avec les maladies, les lois et la religion. 2ª Edición española, Barcelona, 1857. p. 382-387.
Spitz R. Anaclitic Depression. Psychoanalytic Study of the Child 1946; 2: 313-242.
American Psychiatric Association [APA]. DSM-IV-TR. Manual diagnóstico y estadístico de los trastornos mentales. Barcelona: Masson; 2002.
American Psychiatric Association [APA]. Diagnostic and Statistical Manual of Mental Disorders. 4th Ed. Washington: American Psychiatric Association; 1994.
Toros F, Bilgin G, Bugdayci R, Sasmaz T, Kurt O, Camdeviren H. Prevalence of Depression as Measured by the CBDI in a Predominantly Adolescent School Population in Turkey. European Psychiatry 2004; 19: 264-271.
Domènech E, Polaino-Lorente A. Epidemiología de la depresión infantil. Barcelona: Publicaciones médicas Espaxs; 1990.
Angold A. Childhood and adolescent depression. Epidemiological and aetiological aspects. British Journal of Psychiatry 1998; 152: 601-617.
Canals J, Doménech E, Pagés R, Ballart J, Henneberg M. Síntomas de depresión en la etapa puberal: primeros resultados de un estudio epidemiológico longitudinal. Actas Luso-Españolas de Neurología, Psiquiatría y Ciencias Afines 1991; 19(3): 155-161.
Ollendick T, Yule W. Depression in British and American children and its relation to anxiety and fear. Journal of Consulting and Clinical Psychology 1990; 58: 126-129. Frigerio A, Pesenti S, Molteni M. Depressive symptoms as measured by the CDI in a population of northern Italian children. European Psychiatry 2001; 16(1): 33-37.
Almqvist F, Kumpulainen K, Ikäheimo K, Linna S, Henttonen I, Huikko E et. al. Behavioural and emotional symptoms in 8-9-yr-old children. European Child & Adolescent Psychiatry 1999; 8(4): 7-16.
Sorensen J, Nissan J, Mors O, Thomsen P. Age and gender difference in depressive symptomatology and comorbidity: an incident sample of psychiatrically admitted children. Journal of affective disorders 2005; 84: 85-91.
Bennett D, Ambrosini P, Kudes D, Metz C, Ravinovich, H. Gender difference in adolescent depression: do symptoms differ for boys and girls? Journal of Affective Disorders 2005; 89: 35-44.
Canals J, Marti-Henneberg C, Fernández-Ballart J, Doménech E. A longitudinal Study of Depression in an Urban Spanish Pubertal Population. European Child and Adolescent Psychiatry 1995; 4(2): 102-111.
Klein DN, Doughert LR, Olino T. Toward guidelines for evidence-based assessment of depression in children and adolescents. Journal of Clinical Child and Adolescent Psychology 2005; 34: 412-432.
Angold A, Costello EJ, Messer SC, Pickles A. Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research 1995; 5: 237-249.
American Psychiatric Association [APA]. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed., revised ed. Washington: American Psychiatric Association; 1987.
Kovacs, M. The Children´s Depression Inventory: A self-rated depression scale for school-aged youngsters. University of Pittsburgh; 1983. Manuscrito no publicado.
Canals J, Domènech E. Síntomas de ansiedad en las depresiones puberales: primeros resultados de un estudio epidemiológico longitudinal. Revista de la Facultad de Psiquiatría de Barna 1990; 173-181.
Seligman L, Ollendick T. Comorbidity of Anxiety and depression in Children and Adolescents: An integrative Review. Clinical Child and Family Psychology Review 1998; 1(2): 125-144.
Rutter, M. Isle of Wight Revisited: Twenty-Five Years of Child Psychiatric Epidemiology. Annual Progress in Child Psychiatry & Child Development 1990; 131-179.
Costello J, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and Development of Psychiatric Disorder in Childhood and Adolescence. Archive General of Psychiatry 2003; 60: 837-844.
Angold A, Costello J. Depressive Comorbidity in Children and Adolescents: empirical, theoretical, and methodological issues. The American Journal of Psychiatry 1993; 150(12): 1779-1791.
Moreno, MA. Comorbilidad de los trastornos por ansiedad en niños y adolescentes. Tesis dirigida por: Lourdes Ezpeleta. Universidad Autónoma de Barcelona; 2000. Biblioteca de Comunició i Hemeroteca General. TUAB/5325.
Ryan ND, Puig-antich J, Ambrosini P, Rabinovich H, Robinson D, Nelson B et al. The clinical picture of Major Depression in children and adolescents. Archive General of Psychiatry 1987; 44: 854-861.
Last, CG, Perrins S, Hersen M, Kazdin AE. DSM-III-R anxiety disorders in children: sociodemographic and clinical characteristics. Journal of American Academy Child and Adolescent Psychiatry 1992; 31: 1070-1076.
Romero K. Sintomatología ansiosa y depresiva en niños de 4to de primaria. [tesina de máster dirigida por Edelmira Doménech-Llaberia y Fina Canals]. Universidad Autónoma de Barcelona; 2008. Biblioteca de Humanitats-Dipósit. TES/5100.
Polaino A, Canals J, Domènech-Llaberia E. Comorbilidad ansiedad-depresión en la infancia y en la adolescencia. Psicopatología 2002; 22(4): 235-255.
Sanford M, Szatmati P, Spinner M, Munroe-Blum H, Jamieson E, Walsh C et al. Predicting the one year course of adolescent major depression. Journal of the American Academy of Child and Adolescent Psychiatry 1995; 34: 1618-1628.
American Psychiatric Association [APA]. DSM-5 development. [internet]. 2011 Nov 3. Disponible en: http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=407
Fristad MA, Emery BL, Beck SJ. Use and abuse of the Children’s Depression Inventory. Journal of Consulting and Clinical Psychology 1997; 65(4): 699-702.
Comer JS, Kendall PC. High-End specificity of the Children’s Depression Inventory in a sample of Anxiety-Disordered youth. Depression and Anxiety 2005; 22: 11-19.
Domènech-Llaberia E, Jané MC, Canals J, Ballespí S, Esparó G, Garralda E. Parental reports of somatic symptoms in preschool children: prevalence and associations in a Spanish Sample. Journal of the American Academy of Child and Adolescent Psychiatry 2004; 43(5):598-604.
Domènech-Llaberia E, Viñas F, Pla E, Jane M, Mitjavila M, Corbella T et al. Prevalence of major depression in preschool children. Eur Child Adolesc Psychiatry 2009; 18: 597-604.
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