Importance of perspective dimensional psychopathology of depression: a proposal of evaluation for Brazilian patients in different settings / A importância da perspectiva dimensional da psicopatologia da depressão: uma proposta de avaliação aos pacientes brasileiros em diferentes contextos

Resumo

Dear Editor, Studies have shown that depressive mood disorder represents a global public health problem. In addition to its high prevalence rates, investigations suggest it is increasing in developing countries such as Brazil(1). Given this scenario, we seek to contribute to the diagnosis and most appropriate treatment for unipolar depressive disorder by adapting and validating an instrument for the dimensional approach to symptom assessment for the Brazilian culture. The SVARAD (Scala per la Valutazione Rapida Dimensionale or Scale for Rapid Dimensional Assessment) is a scale that allows the valid and reliable assessment of the main psychopathological dimensions in patients with depression. Developed at a European university, its primary objective is to facilitate intensive medical care practices in various settings, including emergency services, without the intention of replacing the more complex and articulated scales used in psychiatry(2). It is a five-point rating scale (0-4) consisting of 10 items, with a quick and simple summation that can be easily used in clinical practice. It explores the following: 1. apprehension/fear, 2. sadness/demoralization, 3. anger/irritability, 4. obsession, 5. apathy, 6. impulsivity, 7. distortion of reality, 8. disorganized thoughts, 9. somatic concern/somatization, and 10. activation. The activation symptoms are defined by three items on this scale: item 3, defined as irritation, anger, resentment, irritability, hostility, verbal or physical violence; item 6, defined as a tendency to suddenly change behavior improperly or with the potential of hurting oneself, without reflecting on the consequences of one's own actions; and item 10, defined as increased motor activity, acceleration of ideas, disinhibition, increased energy and self-confidence, euphoria or irritability(2).