Associação entre fatores psicológicos, níveis de cortisol e proteína C-reativa em indivíduos em tratamento para hanseníase de um hospital universitário

Abstract

Leprosy is a chronic disease with clinical and immunological manifestations and is associated with psychological comorbidities, just as these comorbidities affect the functioning of the immune system, involving the context of psychoneuroimmunology. This research aimed to analyze the health-disease process from the individual's perspective and the association between psychological factors, leprosy reactions and cortisol and C-reactive protein levels during leprosy treatment at the University Hospital of the Federal University of Juiz de Fora/ Brazilian Hospital Services Company. A case series study was carried out using a longitudinal exploratory design with a quantitativequalitative approach. Symptoms of depression and anxiety, stress, stigma, presence of leprosy reaction, cortisol and C-reactive protein levels and perception of vulnerability to the disease were measured at 3 moments during leprosy treatment, and the perception of the health-disease process was investigated through interviews at the beginning and end of treatment. To compare instrument scores between the three assessments, Repeated Measures Analysis of Variance was performed; for correlations at each moment of treatment, Pearson's correlation was used between continuous variables, and between categorical and continuous variables, point-biserial correlation; and in relation to the interviews, Bardin's content analysis was carried out. Among the main findings, we can highlight the presence of symptoms of anxiety, depression and stress in individuals with leprosy, the presence of stigma, the reduction of anxiety symptoms throughout treatment and the association between stress and other psychological and leprosy reactions during the leprosy treatment period. These results support the need to implement diagnostic and control strategies for psychological aspects such as depression, anxiety and stress in individuals with leprosy, also aiming to control possible leprosy reactions; in addition to adding measures to combat stigma and incorporating an interprofessional health team to care for individuals with leprosy.