Salud Pública de México (Oct 2004)
Influencia de los sucesos vitales y el apoyo social en una intervención psicoeducativa para mujeres con depresión The influence of life events and social support in a psycho-educational intervention for women with depression
Abstract
OBJETIVO: Investigar la influencia del apoyo social y los sucesos vitales sobre los síntomas de depresión: pretratamiento, postratamiento (15-30 días) y seguimiento (cuatro meses), en una intervención psicoeducativa para depresión. MATERIAL Y MÉTODOS: Se seleccionaron 254 mujeres con síntomas de depresión, de entre quienes solicitaron atención para dichos síntomas, en tres centros comunitarios de salud mental y un centro de salud de la Secretaría de Salud, en la Ciudad de México, entre enero de 1998 y diciembre de 2000. La intervención había mostrado previamente su eficacia en reducir los síntomas de depresión. Dichos síntomas se evaluaron con la Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D), y los sucesos vitales y el apoyo social con escalas específicas para estos aspectos. Se realizaron análisis de regresión jerárquica para probar los diversos modelos. RESULTADOS: Modelo 1: efecto de sucesos vitales, apoyo social y variables sociodemográficas (edad, escolaridad, ingreso y ocupación) sobre CES-D pretratamiento. El modelo fue significativo (pOBJECTIVE: To investigate the influence of social support and adverse life events on depression symptoms, before and after therapy (15-30 days) and during follow-up (4 months) of a psycho-educational intervention for depression. MATERIAL AND METHODS: The study population consisted of 254 women with depression symptoms selected among those seeking treatment for their symptoms in three community mental health centers and in one Ministry of Health center, all of them in Mexico City, between January 1998 and December 2000. The intervention has been proved effective previously in reducing depression symptoms. Symptoms were assessed using Radloff's CES-D scale, while specifically designed scales were used for events and social support. Hierarchical regression analyses were carried out to test various models. RESULTS: Model 1: effect of variables: life events, social support, and socio-demographic variables (age, education level, income, and work status) on CES-D pre-treatment. The model was significant (p<0.000) and the first two variables and age were included in the model. Model 2: effect of the same predictive variables on CES-D post-treatment. The model was significant (p<0.001) and included social support and life events. Model 3: effect of the same variables on CES-D during follow-up. The model was significant (p<0.000) and included life events and educational achievement. Model 4: effect of social support and life events during follow-up on CES-D during follow-up. The model was also significant (p<0.000) and both variables were included in the model. Additional analyses for models 2 and 3 adding CES-D pre-treatment as a predictor showed that only the latter was significant. CONCLUSIONS: Life events and social support are associated with initial depression symptoms and also predict the reduction of symptoms following the psycho-educational intervention. This may be due to the high correlation of life events and social support with CES-D pre-treatment. Life events and social support following the intervention also have an effect on CES-D in this same stage.
