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Objective. To determine the existence of association between depressive symptoms and mortality in older individuals in Latin America. Method. A systematic review with meta-analysis was performed based on published studies indexed in PubMed, Scientific Electronic Library Online (SciELO), Web of Science, Cochrane Library, Scopus, and LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde). The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), and structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Meta-analysis was performed using random effects models, and the data analyzed included crude relative risk (RR) and heterogeneity, with poin estimates and 95% confidence intervals (95%CI). Results. Five studies, performed in Brazil and Mexico, were included in the meta-analysis, for a total of 8 954 older individuals. RR for mortality in the presence of depressive symptoms was 1.44 (95%CI: 1.16; 1.78). Heterogeneity was 80.87%. Meta-regression showed that the higher the proportion of women in the sample, the higher the mortality risk associated with depressive symptoms; and that the longer the study follow-up, the lower the risk of mortality associated with depressive symptoms. Conclusion. The presence of depressive symptoms was positively associated with mortality in older Latin American individuals. The RR for death was 44.0% higher in individuals with depressive symptoms as compared to those without depressive symptoms. The main study limitations were the lower number of studies retrieved through systematic review and the variety of scales used to determine the presence of depressive symptoms. [ABSTRACT FROM AUTHOR]

Objective. To assess the association between intersectional disadvantage and clinically significant depressive symptoms (CSDS), describing the magnitude of social inequalities in the prevalence of symptoms among adult women in Tijuana, Mexico. Methods. This was a cross-sectional study. CSDS were assessed using the Centers for Epidemiological Studies Depression Scale among a probability sample of 2 345 women from 18 -- 65 years of age in 2014. CSDS prevalence was calculated according to categories of three social stratifiers: socioeconomic status (SES), educational attainment, and fertility (number of children). Social inequality was measured with the slope index of inequality (SII) and the concentration index (CIx). Intersectionality among stratifiers was explored descriptively and with multivariable regression analysis. Results. CSDS prevalence was 17.7% (95%CI: 15.1% -- 21.0%). The SII and CIx showed inequity in all social stratifiers. The absolute difference in CSDS prevalence between the lowest and highest ends of the SES gradient was 21.9% (95%CI: 21.5% -- 22.4%). Among the most disadvantaged women, i.e., those at the intersection of lowest SES, lowest educational attainment, and highest fertility, the CSDS prevalence was 39.5% (95% CI: 26.0% -- 52.9%). Conclusions. Disadvantage along multiple axes was associated with CSDS. Efforts to improve the mental health of women should include equity-oriented policies that address its social determinants. [ABSTRACT FROM AUTHOR]

Objective. To describe the estimated prevalence of noncommunicable diseases and their common risk factors among the adult population of Curitiba, Paraná, Brazil, based on results of the EPIdemiology of CURitiba: EvaluAtion of Noncommunicable diseases (EPICUREAN) study. Methods. This was a cross-sectional, population-based survey of 1 103 residents of Curitiba, grouped by age (18 - 39 years of age, 40 - 59, and ≥ 60 years), conducted in August 2013 - August 2014. Household interviews, anthropometry, blood pressure measurements, and fasting capillary glycemia were performed during two visits to each participant. The analyses included frequency distribution and prevalence estimates of main outcomes. Prevalence estimates, weighted by age and sex, were presented as absolute numbers and percentages. Results. Prevalence estimates for self-reported depression were 21.2%; hypertension, 31.2%; diabetes, 9.1%; self-reported dyslipidemia, 21.7%; obesity, 21.2%; current smoking, 16.1%; binge drinking, 23.4%; and insufficient physical activity, 35.1%. Prevalences of diabetes and hypertension were higher among individuals with less schooling and the elderly. Binge drinking and leisure-time physical activity were more prevalent in young adults. Men presented higher prevalences of overweight, current smoking, and harmful use of alcohol. Obesity and moderateto- severe risk of depression were more frequent among women and those with lower income. Conclusions. The prevalence of NCDs and common risk factors among the adult population of Curitiba are high and reveal a gradient of vulnerabilities by age, sex, education level, and income. To address health inequities and meet the needs of different population groups, the health system should monitor NCDs and risk factors and implement equitable public health policies. [ABSTRACT FROM AUTHOR]

Objective. Analyze results with respect to cortisol reactivity (CR) in experimental stress paradigms in adults with or without a psychiatric disorder who suffered violence in early developmental stages (infancy or early adolescence); and use these results to propose a clinical tool to determine biological stress indicators. Methods. A systematic review was conducted using several databases and following PRISMA criteria; of a total of 231 articles, 16 satisfied the inclusion criteria and the results were analyzed qualitatively. Results. Despite heterogeneity, the results suggested that the people who suffered violence at an early age present a pattern of low CR. In contrast, people who also developed symptoms of post-traumatic stress disorder and depression, regardless of the type of violence, showed increased CR. The majority of studies focused on people who suffered childhood sexual abuse and half of the articles supported the hypothesis that CR is more pronounced in men than in women. Conclusions. The results of this review suggest that cortisol hyperreactivity can be considered a biomarker for treatment and intervention in people with post-traumatic stress disorder and depression who suffered violence at an early age. The results also support evidence that experiencing violence alters stress response and mental health in the long term. However, it is necessary to conduct more studies, in particular studies on hyporeactivity and gender differences. [ABSTRACT FROM AUTHOR]