Pesquisa y diagnóstico de trastorno depresivo en una comunidad rural de Venezuela.
Screening and diagnosis of depressive disorder in a rural community in Venezuela.
Keywords:
depressive disorder, PHQ-9, unemployment, Venezuela, rural health
Abstract
The COVID-19 pandemic has triggered a global increase in the incidence of psychological consultations related to anxiety and depressive disorder, which, together with the humanitarian crisis in Venezuela, produced a surge in reported cases of these pathologies nationwide. Currently, there are no works available that document the prevalence of depressive disorder in rural communities in Venezuela. This work aimed to determine the prevalence of depressive disorder in La Marroquina, a rural community in Yaracuy State, Venezuela, through a cross-sectional study conducted in July 2022, with an estimated population of 611 patients and a sample of 160. The study included two phases: a brief interview, where the Patient Health Questionnaire 9 (PHQ-9) was conducted and in a second phase, an interview with a Psychiatry specialist who used the Hamilton Depression Scale (HAM-D) for the diagnosis of depression. In the psychiatric triage for depression, 67 patients obtained PHQ-9 scores >10 points, of which only 39 attended a consultation. When performing the psychiatric evaluation of these patients, the depressive disorder was diagnosed in 30 patients, with a prevalence in the community of La Marroquina of 18.75%. A statistically significant association was found between the risk of depression according to the PHQ-9 and unemployment. The fact that the scales do not allow differentiating between different types of depressive disorder, as well as the social stigma of attending a psychiatric consultation, may cause underreporting in our study. La Marroquina has a high prevalence of depressive disorder, which is related to unemployment as the most important risk factor.
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References
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Lok V, Sjöqvist H, Sidorchuk A, Flodin P, Osika W, Daly M, Hyland P, Andersen LH, Fallesen P, Cabrera MC, Knudsen AKS, Wetherall K, Widnall E, Groarke JM, Armour C, Dalman C, Hollander AC, Niemi M. Changes in anxiety and depression during the COVID-19 pandemic in the European population: A meta-analysis of changes and associations with restriction policies. Eur. Psychiatry 2023; 66(1):1-12.
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Probst JC, Laditka SB, Moore CG, Harun N, Powell MP, Baxley EG. Rural-urban differences in depression prevalence: implications for family medicine. Fam Med 2006; 38(9): 653-660.
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Cassiani-Miranda CA, Vargas-Hernández MC, Pérez-Aníbal E, Herazo-Bustos MI, Hernández-Carrillo M. Confiabilidad y dimensión del cuestionario de salud del paciente (PHQ-9) para la detección de síntomas de depresión en estudiantes de ciencias de la salud en Cartagena, 2014. Biomedica 2017; 37: 112-120.
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Griffiths KM, Christensen H, Jorm AF. Predictors of depression stigma. BMC Psychiatry 2008; 8(1): 1-12.
Lynch H, McDonagh C, Hennessy E. Social anxiety and depression stigma among adolescents. J Affect Disord 2021; 281: 744-750.
Peluso Ede T , Blay SL. Public stigma in relation to individuals with depression. J Affec. Disord 2009; 115(1-2): 201-206.
Yokoya S, Maeno T, Sakamoto N, Goto R, Maeno T. A brief survey of public knowledge and stigma towards depression. J Clin Med Res 2018; 10(3): 202-209.
Prizeman K, Weinstein N, McCabe C. Effects of mental health stigma on loneliness, social isolation, and relationships in young people with depression symptoms. BMC Psychiatry 2023; 23(1): 527-541.
Al-Shannaq Y, Jaradat D, Wafa’a F, Jaradat D. Depression stigma, depression literacy, and psychological help seeking attitudes among school and university students. Arch Psychiatr Nurs 2023; 46: 98-106.
Navarro Gómez N, Trigueros Ramos R. Estigma en los profesionales de la Salud Mental: una revisión sistemática. Psychology, Society & Education 2019; 11(2):253-266.
Rajan S, McKee M, Rangarajan S, Bangdiwala S, Rosengren A, Gupta R, Kutty VR, Wielgosz A, Lear S, AlHabib KF, Co HU, Lopez-Jaramillo P, Avezum A, Seron P, Oguz A, Kruger IM, Diaz R, Nafiza MN, Chifamba J, Yeates K, Kelishadi R, Sharief WM, Szuba A, Khatib R, Rahman O, Iqbal R, Bo H, Yibing Z, Wei L, Yusuf S. Association of symptoms of depression with cardiovascular disease and mortality in low, middle, and high-income countries. JAMA Psychiatry 2020; 77(10): 1052-1063.
Ma S, Yang J, Yang B, Kang L, Wang P, Zhang N, Wang W, Zong X, Wang Y, Bai H, Guo Q, Yao L, Fang L, Liu Z. The Patient Health Questionnaire-9 vs. the Hamilton Rating Scale for Depression in assessing major depressive disorder. Front Psychiatry 2021; 12: 747139-48.
Sun Y, Fu Z, Bo Q, Mao Z, Ma X, Wang C. The reliability and validity of PHQ-9 in patients with major depressive disorder in psychiatric hospital. BMC Psychiatry 2020; 20(1): 474-480.
Ridley M, Rao G, Schilbach F, Patel V. Poverty, depression, and anxiety: Causal evidence and mechanisms. Science 2020; 370(6522): 1-12.
Romans S, Cohen M, Forte T. Rates of depression and anxiety in urban and rural Canada. Soc. Psychiatry Psychiatr. Epidemiol. 2011; 46(7): 567-575.
Vázquez Machado A. Factores psicosociales asociados a la depresión en un grupo de mujeres venezolanas. Rev Hosp Psiquiatrico Habana 2013; 10(2): 1-11.
Álvaro JL, Garrido A, Pereira CR, Torres AR, Barros SC. Unemployment, selfesteem, and depression: differences between men and women. Span. J Psychol 2019; 22: 1-9.
Zuelke AE, Luck T, Schroeter ML, Witte AV, Hinz A, Engel C, Enzenbach C, Zachariae S, Loeffler M, Thiery J, Villringer A, Riedel-Heller SG. The association between unemployment and depression-Results from the population-based LIFE-adult-study. J. Affect. Disord. 2018; 235: 399-406.
Organización Mundial de la Salud. Informe mundial sobre salud mental: transformar la salud mental para todos. 2022, Geneva: Organización Mundial de la Salud: 28. Disponible en: https://www.who.int/es/publications/i/item/9789240050860.
Rivas-Sucari D, Rodríguez-Eguizabal JL, Rivas-Sucari HC. Reflections on anxiety and depression disorders in pandemic times. Gac. Med. Mex. 2024; 160(2): 225-226.
Lok V, Sjöqvist H, Sidorchuk A, Flodin P, Osika W, Daly M, Hyland P, Andersen LH, Fallesen P, Cabrera MC, Knudsen AKS, Wetherall K, Widnall E, Groarke JM, Armour C, Dalman C, Hollander AC, Niemi M. Changes in anxiety and depression during the COVID-19 pandemic in the European population: A meta-analysis of changes and associations with restriction policies. Eur. Psychiatry 2023; 66(1):1-12.
GBD 2015 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2013;2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet 2016; 388(10053): 1603-1658.
Marulanda MI, Aquino Y, Piña S, Torres L, Ugel E, Durán M, González-Rivas JP, Nieto-Martínez R. Resúmenes de los trabajos de la Pirámide de Investigadores del EVESCAM presentados en el XXIV Congreso Venezolano de Medicina Interna. Med. Interna 2018; 34(4): 245-255.
Baptista T, Valero E, Novoa Montero D, Torres RA. Prevalencia de algunos trastornos mentales espefíficos en cuatro comunidades rurales en Trujillo, Venezuela. Arch Venez Psiquiatr Neurol 1999; 45(93):17-27.
Probst JC, Laditka SB, Moore CG, Harun N, Powell MP, Baxley EG. Rural-urban differences in depression prevalence: implications for family medicine. Fam Med 2006; 38(9): 653-660.
Wang JL. Rural–urban differences in the prevalence of major depression and associatedimpairment. Soc. Psychiatry Psychiatr Epidemiol 2004; 39(1): 19-25.
Rost K, Zhang M, Fortney J, Smith J, Smith GR, Jr. Rural-urban differences in depression treatment and suicidality. Med. Care 1998; 36(7): 1098-1107.
Saha A, Mandal B, Muhammad T, Ali W. Decomposing the rural–urban differences in depression among multimorbid older patients in India: evidence from a cross- sectional study. BMC Psychiatry 2024; 24(1): 60-77.
Jeong JA, Kim SA, Yang JH, Shin MH. Urban-rural differences in the prevalence of depressive dymptoms in Korean adults. Chonnam Med. J. 2023; 59(2): 128-133.
Xu C, Miao L, Turner D, DeRubeis R. Urbanicity and depression: A global meta- analysis. J Affect Disord 2023; 340: 299-311.
Fortney JC, Harman JS, Xu S, Dong F. The association between rural residence and the use, type, and quality of depression care. J. Rural Health 2010; 26(3): 205-213.
Rodriguez A, Meneses J, Transformaciones rurales en América Latina y sus relaciones con la población rural. 2011, Chile: Comisión Económica para América Latina y el Caribe: 45. Disponible en: https://hdl.handle.net/10986/8317.
Chomitz KM, Buys P, Thomas TS, Quantifying the rural-urban gradient in Latin America and the Caribbean. Vol. 3634. 2005: World Bank Publications.
Proyecto Mayū. Disponible en: https:// proyectomayu.com/.
Caritas Venezuela. Mapas de geolocalización. 2024. Disponible en: https://caritas- venezuela.org/mapas-y-boletines/mapas-de-geolocalizacion/.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16(9): 606-613.
Zimmerman M, Martinez JH, Young D, Chelminski I, Dalrymple K. Severity classification on the Hamilton depression rating scale. J Affect Disord 2013; 150(2): 384-388.
Hamilton M. A Rating Scale for Depression. 1960; 23(1): 56-62.
Campo-Arias A, Pedrozo-Pupo JC, Cogollo-Milanés Z. PHQ-9 in screening of major depressive episode among COVID-19 survivors. Rev Colomb Psiquiatr (Engl Ed) 2023; 52(3): 173-175.
Cassiani-Miranda CA, Vargas-Hernández MC, Pérez-Aníbal E, Herazo-Bustos MI, Hernández-Carrillo M. Confiabilidad y dimensión del cuestionario de salud del paciente (PHQ-9) para la detección de síntomas de depresión en estudiantes de ciencias de la salud en Cartagena, 2014. Biomedica 2017; 37: 112-120.
World Medical Association. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants. JAMA 2024.
Griffiths KM, Christensen H, Jorm AF. Predictors of depression stigma. BMC Psychiatry 2008; 8(1): 1-12.
Lynch H, McDonagh C, Hennessy E. Social anxiety and depression stigma among adolescents. J Affect Disord 2021; 281: 744-750.
Peluso Ede T , Blay SL. Public stigma in relation to individuals with depression. J Affec. Disord 2009; 115(1-2): 201-206.
Yokoya S, Maeno T, Sakamoto N, Goto R, Maeno T. A brief survey of public knowledge and stigma towards depression. J Clin Med Res 2018; 10(3): 202-209.
Prizeman K, Weinstein N, McCabe C. Effects of mental health stigma on loneliness, social isolation, and relationships in young people with depression symptoms. BMC Psychiatry 2023; 23(1): 527-541.
Al-Shannaq Y, Jaradat D, Wafa’a F, Jaradat D. Depression stigma, depression literacy, and psychological help seeking attitudes among school and university students. Arch Psychiatr Nurs 2023; 46: 98-106.
Navarro Gómez N, Trigueros Ramos R. Estigma en los profesionales de la Salud Mental: una revisión sistemática. Psychology, Society & Education 2019; 11(2):253-266.
Rajan S, McKee M, Rangarajan S, Bangdiwala S, Rosengren A, Gupta R, Kutty VR, Wielgosz A, Lear S, AlHabib KF, Co HU, Lopez-Jaramillo P, Avezum A, Seron P, Oguz A, Kruger IM, Diaz R, Nafiza MN, Chifamba J, Yeates K, Kelishadi R, Sharief WM, Szuba A, Khatib R, Rahman O, Iqbal R, Bo H, Yibing Z, Wei L, Yusuf S. Association of symptoms of depression with cardiovascular disease and mortality in low, middle, and high-income countries. JAMA Psychiatry 2020; 77(10): 1052-1063.
Ma S, Yang J, Yang B, Kang L, Wang P, Zhang N, Wang W, Zong X, Wang Y, Bai H, Guo Q, Yao L, Fang L, Liu Z. The Patient Health Questionnaire-9 vs. the Hamilton Rating Scale for Depression in assessing major depressive disorder. Front Psychiatry 2021; 12: 747139-48.
Sun Y, Fu Z, Bo Q, Mao Z, Ma X, Wang C. The reliability and validity of PHQ-9 in patients with major depressive disorder in psychiatric hospital. BMC Psychiatry 2020; 20(1): 474-480.
Ridley M, Rao G, Schilbach F, Patel V. Poverty, depression, and anxiety: Causal evidence and mechanisms. Science 2020; 370(6522): 1-12.
Romans S, Cohen M, Forte T. Rates of depression and anxiety in urban and rural Canada. Soc. Psychiatry Psychiatr. Epidemiol. 2011; 46(7): 567-575.
Vázquez Machado A. Factores psicosociales asociados a la depresión en un grupo de mujeres venezolanas. Rev Hosp Psiquiatrico Habana 2013; 10(2): 1-11.
Álvaro JL, Garrido A, Pereira CR, Torres AR, Barros SC. Unemployment, selfesteem, and depression: differences between men and women. Span. J Psychol 2019; 22: 1-9.
Zuelke AE, Luck T, Schroeter ML, Witte AV, Hinz A, Engel C, Enzenbach C, Zachariae S, Loeffler M, Thiery J, Villringer A, Riedel-Heller SG. The association between unemployment and depression-Results from the population-based LIFE-adult-study. J. Affect. Disord. 2018; 235: 399-406.
Published
2025-03-06
How to Cite
Leyva, J., Luna-Ladera, K., Iglesias-Gómez, M., Rodríguez- Rizk, V., Affinito, M., Contreras-Montañez, Y., Celis, R., Pulido Febres, M., Costa-Müller, J., & Omaña-Ávila, Óscar. (2025). Pesquisa y diagnóstico de trastorno depresivo en una comunidad rural de Venezuela.: Screening and diagnosis of depressive disorder in a rural community in Venezuela. Investigación Clínica, 66(1), 26-38. https://doi.org/10.54817/IC.v66n1a03
Section
Original Works
