Anxiety and depression are prevalent mental disorders around the world. The etiology of both diseases is multifactorial, involving biological and psychological issues. The COVID-19 pandemic settled in 2020 and culminated in several changes in the routine of individuals around the world, affecting mental health. People infected with COVID-19 are at greater risk of developing anxiety and depression, and individuals previously affected by these disorders have worsened the condition. In addition, individuals diagnosed with anxiety or depression before being affected by COVID-19 developed the severe illness at higher rates than individuals without mental disorders. This harmful cycle involves several mechanisms, including systemic hyper-inflammation and neuroinflammation. Furthermore, the context of the pandemic and some previous psychosocial factors can aggravate or trigger anxiety and depression. Disorders are also risks for a more severe picture of COVID-19. This review discusses research on a scientific basis, which brings evidence on biopsychosocial factors from COVID-19 and the context of the pandemic involved in anxiety and depression disorders.
Neuroinflammation is closely related to the development of depression, since the latter is caused, among other factors, by inflammatory processes, mainly related to the activation of microglia and expression of specific genes, which occurs during the neuroinflammatory process. Thus, COVID-19 is an important risk factor for the development of depression, since in addition to generating the feeling of stress, which also increases the activity of the immune system, it is also the cause of pathological processes and physiological ones that lead to the development of neuroinflammation, microglial activation, gene expression dysfunction and decreased concentration of available serotonin. That said, drugs are being used to combat COVID-19 to reduce the oxidative stress presented in the disease. Thus, tramadol and fluoxetine are highlighted as drugs used, however, although they present some positive results, such as the reduction of pro-inflammatory cytokines, they are also associated with negative effects such as dependence, pulmonary, cardiac and brain impairment. From this, the purinergic system is highlighted in the literature as a possible therapeutic target. This is because its mechanisms are related to the regulation of microglia, astrocytes and the physiology of important neurotransmitters and hormones. Added to this, there is a modulation of inflammatory activity, especially with regard to the P2X7 receptors of this system. The latter is an important target for the treatment of depression and COVID-19, since positive results were obtained through the genetic exclusion of this receptor and the use of selective antagonists. Graphical Abstract
Objetivo: identificar em publicações científicas quais estratégias de ensino aprendizagem são discutidas para fomentar a formação clínica do graduando em enfermagem. Método: Trata-se de uma Revisão Integrativa de Literatura (RIL) fundamentada na abordagem metodológica proposta por Whittemore e Knafl, seguindo as diretrizes do guideline Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Desenvolveu-se em cinco etapas: 1) elaboração da questão de pesquisa (identificação do problema); 2) busca por estudos primários; 3) avaliação dos estudos pelos critérios de inclusão e exclusão; 4) análise dos dados dos estudos primários; e 5) apresentação da revisão. A coleta de dados ocorreu de abril a setembro de 2021. Resultados: Dos 487 artigos inicialmente selecionados foram incluídos 13 artigos originais, que atenderam aos critérios estabelecidos. Os artigos sugerem que as estratégias de ensino-aprendizagens problematizadoras e a atuação do tutor no uso dessas estratégias potencializam o desenvolvimento de competências para a formação clínica. Considerações Finais:Conclui-se que as estratégias utilizadas para formação clínica precisam estar alicerçadas na problematização, o que requer tutores abertos a mudanças e avanços no modo de ensinar e instituições de ensino que estimulem o processo contínuo de formação docente. Enseja-se, assim, a expertise clínica como modelo indutor para a profissionalização da enfermagem, que a fortalece e demonstra o espaço que a profissão vem alcançando ao longo de sua atuação e inserção social no campo da saúde.
SAÚDE DO HOMEM: IMPACTOS RELACIONADOS AO GÊNERO DIANTE DO COVID 19izane caroline borba pires anna clara menezes padovani andreza fernanda matias amaral luana maria da silva rodrigues
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