Depression, quality of life, subjective well-being, and psychometric assessments in Brazilian patients with Chagas disease: A literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v14i7.49284

Keywords:

Chagas disease, Psychological assessment, Psychometric instruments, Quality of life, Depression, Subjective well-being.

Abstract

Chagas Disease (CD) has a significant impact on the health of the Latin American population. It primarily affects low-income individuals, people with low levels of education, and residents of rural areas and poor neighborhoods of large urban centers. One-third of affected individuals may develop symptoms that interfere with their lives, reducing their ability to work and leading to discrimination. This restrictive and adverse reality can generate psycho-affective disorders that manifest in social, family, and work relationships. Studies have shown that patients with CD may exhibit psychological changes, both cognitive and related to the perception of well-being, showing an association with depression, sadness, reduced quality of life, higher stress levels, and lower resilience. The present study aims to conduct a literature review of the psychometric assessment of depression, quality of life, and subjective well-being in Brazilian patients with CD. A literature review was conducted based on a search of databases from 2005 to 2023. A total of 158 articles were identified, of which 26 were eligible for analysis. Among the studies that analyzed the psychosocial nature of CD, the majority focused on socio-anthropological issues, using interviews that emphasized socioeconomic, non-measurable, symbolic, and cultural aspects. Few studies have utilized instruments with robust psychometric properties. Advancing knowledge in the psychosocial context requires the use of rigorously validated psychometric tools for the psychological assessment of patients with CD.

References

Almeida Lins, W. M., Tura, B. R., & Kasal, D. A. (2021). The Association Between Physical Performance and Health-Related Quality of Life Based on the EQ-5D-3L Questionnaire in Patients With Chagas Disease. Value in Health Regional Issues, 26, 191–196. https://doi.org/10.1016/j.vhri.2021.09.002

American Psychiatric Association. (2014). Manual diagnóstico e estatístico de transtornos mentais: DSM-5 (5. ed). Artmed Editora.

American Thoracic Society. (2004). The Minnesota Living with Heart Failure Questionnaire. New York: American Thoracic Society. https://www.thoracic.org/members/assemblies/assemblies/srn/questionaires/mlhf.php

Arsuaga, M., De Miguel Buckley, R., De La Calle-Prieto, F., & Díaz-Menéndez, M. (2024). Imported infectious diseases in migrants from Latin America: A retrospective study from a referral centre for tropical diseases in Spain, 2017–2022. Travel Med. Infect. Dis, 59, 102708. https://doi.org/10.1016/j.tmaid.2024.102708

Ávila, M. R., Figueiredo, P. H. S., Lima, V. P., Silva, W. T., Vianna, M. V. A., Fernandes, L. H. C., De Azevedo, A. C. A., Lima, M. M. O., De Carvalho Bastone, A., Do Carmo Pereira Nunes, M., Mediano, M. F. F., Da Costa Rocha, M. O., & Costa, H. S. (2021). Accuracy of health‐related quality of life in identifying systolic dysfunction in patients with Chagas cardiomyopathy. Tropical Medicine & International Health, 26(8), 936–942. https://doi.org/10.1111/tmi.13590

Bagattini, Â. M., Camey, S. A., Miguel, S. R., Andrade, M. V., De Souza Noronha, K. V. M., De C. Teixeira, M. A., Lima, A. F., Santos, M., Polanczyk, C. A., & Cruz, L. N. (2018). Electronic Version of the EQ-5D Quality-of-Life Questionnaire: Adaptation to a Brazilian Population Sample. Value Health Reg Issues, 17, 88–93. https://doi.org/10.1016/j.vhri.2017.11.002

Beck, A. T. (1961). An Inventory for Measuring Depression. Archives of General Psychiatry, 4(6), 561. https://doi.org/10.1001/archpsyc.1961.01710120031004

Beck, A. T., Steer, R. A., & Brown, G. K. (2011). Inventário de Depressão de Beck—Segunda Edição (BDI-II) (1o edição). Editora Casa do Psicólogo.

Böckerman, P., Johansson, E., & Saarni, S. I. (2011). Do established health-related quality-of-life measures adequately capture the impact of chronic conditions on subjective well-being? Health Policy, 100(1), 91–95. https://doi.org/10.1016/j.healthpol.2010.10.008

Borsa, J. C., Damásio, B. F., & Bandeira, D. R. (2012). Adaptação e validação de instrumentos psicológicos entre culturas: Algumas considerações. Paidéia (Ribeirão Preto), 22(53), 423–432. https://doi.org/10.1590/S0103-863X2012000300014

Brown, T. A. (2015). Confirmatory factor analysis for applied research (Second Edition). Guilford publications.

Cardoso, R., Batista Sa, L., Garcia, D., Ansari, M., Macedo, F., Benjo, A., Ghatak, A., Motta, T., Motta, I., Tamariz, L., Mitrani, R. D., & Coffey, J. O. (2014). Quality of life determinants in a population of pacemaker patients with a high prevalence of Chagas disease. Int. J. Cardiol, 177(3), 1137–1139. https://doi.org/10.1016/j.ijcard.2014.08.046

Cavalcanti, M. A. F., Nascimento, E. G. C. D., Alchieri, J. C., & Andrade, C. D. M. (2019). Manifestações e estratégias de enfrentamento da Doença de Chagas que interferem na qualidade de vida do indivíduo: Uma revisão sistemática. Ciência & Saúde Coletiva, 24(4), 1405–1416. https://doi.org/10.1590/1413-81232018243.11842017

Chambela, M. C., Mediano, M. F. F., Ferreira, R. R., Japiassú, A. M., Waghabi, M. C., Da Silva, G. M. S., & Saraiva, R. M. (2017). Correlation of 6‐min walk test with left ventricular function and quality of life in heart failure due to Chagas disease. Tropical Medicine & International Health, 22(10), 1314–1321. https://doi.org/10.1111/tmi.12939

Chambela, M. D. C., Mediano, M. F. F., Carneiro, F. M., Ferreira, R. R., Waghabi, M. C., Mendes, V. G., Oliveira, L. D. S., De Holanda, M. T., De Sousa, A. S., Da Costa, A. R., Xavier, S. S., Da Silva, G. M. S., & Saraiva, R. M. (2020). Impact of pharmaceutical care on the quality of life of patients with heart failure due to chronic Chagas disease: Randomized clinical trial. British Journal of Clinical Pharmacology, 86(1), 143–154. https://doi.org/10.1111/bcp.14152

Ciconelli, R. M., Ferraz, M., Santos, W., Meinão, I., & Quaresma, M. V. (1999). Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Rev bras reumatol, 39(3), 143–150.

Cirelli, M. A., Lacerda, M. S., Lopes, C. T., De Lima Lopes, J., & De Barros, A. L. B. L. (2018). Correlations between stress, anxiety and depression and sociodemographic and clinical characteristics among outpatients with heart failure. Arch. Psychiatr. Nurs, 32(2), 235–241. https://doi.org/10.1016/j.apnu.2017.11.008

Costa, H. S., Lima, M. M. O., Figueiredo, P. H. S., Chaves, A. T., Nunes, M. C. P., & Da Costa Rocha, M. O. (2019). The prognostic value of health-related quality of life in patients with Chagas heart disease. Quality of Life Research, 28(1), 67–72. https://doi.org/10.1007/s11136-018-1980-7

Dessotte, C. A. M., Grotti, E. M. D. O., Ignácio, I. B., Fernandes, P. A., Maier, S. R. D. O., Rossi, L. A., & Dantas, R. A. S. (2022). Comparison of Anxiety and Depression Symptoms in Individuals According to their Sex, Type of Cardiac Device, and Diagnosis of Chagas Disease. Brazilian Journal of Cardiovascular Surgery, 37(4). https://doi.org/10.21470/1678-9741-2021-0392

Dias, J. C. P., Ramos Jr., A. N., Gontijo, E. D., Luquetti, A., Shikanai-Yasuda, M. A., Coura, J. R., Torres, R. M., Melo, J. R. da C., Almeida, E. A. de, Oliveira Jr., W. de, Silveira, A. C., Rezende, J. M. de, Pinto, F. S., Ferreira, A. W., Rassi, A., Fragata Filho, A. A., Sousa, A. S. de, Correia, D., Jansen, A. M., Alves, R. V. (2016). 2nd Brazilian Consensus on Chagas Disease, 2015. Rev Soc Bras Med Trop, 49(suppl 1), 3–60. https://doi.org/10.1590/0037-8682-0505-2016

Fleck, M. P., Louzada, S., Xavier, M., Chachamovich, E., Vieira, G., Santos, L., & Pinzon, V. (2000). Aplicação da versão em português do instrumento abreviado de avaliação da qualidade de vida “WHOQOL-bref”. Rev Saude Publica, 34(2), 178–183. https://doi.org/10.1590/S0034-89102000000200012

Giacomoni, C. H. (2004). Bem-estar subjetivo: Em busca da qualidade de vida. Temas em Psicologia, 12(1), 43–50.

Hasslocher-Moreno, A. M., Saraiva, R. M., Brasil, P. E. A. A. do, Sangenis, L. H. C., Xavier, S. S., Sousa, A. S. de, Sperandio-da-Silva, G. M., Mendes, F. de S. N. S., Costa, A. R. da, Holanda, M. T. de, Veloso, H. H., Mazzoli-Rocha, F., Carneiro, F. M., Portela, L. F., & Mediano, M. F. F. (2021). Temporal changes in the clinical-epidemiological profile of patients with Chagas disease at a referral center in Brazil. Revista da Sociedade Brasileira de Medicina Tropical, 54, e0040-2021. https://doi.org/10.1590/0037-8682-0040-2021

Hueb, M. F. D., & Loureiro, S. R. (2005). Revisão: Aspectos cognitivos e psicossociais associados a Doença de Chagas. Psicologia Em Estudo, 10(1), 137–142. https://doi.org/10.1590/S1413-73722005000100016

Hueb, M. F. D., & Loureiro, S. R. (2006). Avaliação da qualidade de vida em uma zona endêmica em doença de Chagas. Rev Soc Bras Med Trop, 39(Suplemento III), 123–125.

Hutz, C., Zanon, C., & Bardagi, M. (2011). Satisfação de Vida. In C. S. Hutz (1 Ed.), Avaliação em psicologia positiva. Artmed Editora.

Jackson, Y., Castillo, S., Hammond, P., Besson, M., Brawand-Bron, A., Urzola, D., Gaspoz, J.-M., & Chappuis, F. (2012). Metabolic, mental health, behavioural and socioeconomic characteristics of migrants with Chagas disease in a non-endemic country. Trop. Med. Int. Health, 17(5), 595–603.

Lozano Beltrán, D. (2021). El Estigma Social Asociado a la Enfermedad de Chagas. Gaceta Medica Boliviana, 44(2), 180–186. https://doi.org/10.47993/gmb.v44i2.331

Marchi, R., & Gurgel, C. (2011). Depressão e doença de Chagas. Rev Soc Bras Med Trop, 95(5), 325–328.

New York Heart Association. (1994). Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels (9o ed). Little, Brown and Co.

Nuzzo, R. (2014). Scientific method: Statistical errors. Nature, 506(7487), 150–152. https://doi.org/10.1038/506150a

Oliveira, B. G., Abreu, M. N. S., Abreu, C. D. G., Rocha, M. O. D. C., & Ribeiro, A. L. (2011). Health-related quality of life in patients with Chagas disease. Revista da Sociedade Brasileira de Medicina Tropical, 44(2), 150–156. https://doi.org/10.1590/S0037-86822011005000002

Oliveira, B. G., Melendez, J. G. V., Ciconelli, R. M., Rincón, L. G., Torres, A. A. S., Sousa, L. A. P. D., & Ribeiro, A. L. P. (2006). The portuguese version, cross-cultural adaptation and validation of specific quality-of-life questionnaire—AQUAREL - for pacemaker patients. Arq. Bras. Cardiol., 87(2). https://doi.org/10.1590/S0066-782X2006001500003

Oliveira, B. G., Velasquez‐Melendez, G., Rincón, L. G., Ciconelli, R. M., Sousa, L. A., & Ribeiro, A. L. (2008). Health‐Related Quality of Life in Brazilian Pacemaker Patients. Pacing and Clinical Electrophysiology, 31(9), 1178–1183. https://doi.org/10.1111/j.1540-8159.2008.01159.x

Oliveira, C. D. L., Cardoso, C. S., Baldoni, N. R., Natany, L., Ferreira, A. M., Oliveira, L. C. D., Nunes, M. D. C. P., Quintino, N. D., Bierrenbach, A. L., Buss, L. F., Haikal, D. S., Cunha Neto, E., Ribeiro, A. L. P., & Sabino, E. C. (2021). Cohort profile update: The main and new findings from the SaMi-Trop Chagas cohort. Revista do Instituto de Medicina Tropical de São Paulo, 63, e75. https://doi.org/10.1590/s1678-9946202163075

Ozaki, Y., Guariento, M. E., & De Almeida, E. A. (2011). Quality of life and depressive symptoms in Chagas disease patients. Quality of Life Research, 20(1), 133–138. https://doi.org/10.1007/s11136-010-9726-1

Pavão, R. B., Moreira, H. T., Pintya, A. O., Haddad, J. L., Badran, A. V., Lima-Filho, M. D. O., Lago, I. M., Chierice, J. R. A., Schmidt, A., & Marin-Neto, J. A. (2021). Aspirin plus verapamil relieves angina and perfusion abnormalities in patients with coronary microvascular dysfunction and Chagas disease: A pilot non-randomized study. Revista da Sociedade Brasileira de Medicina Tropical, 54, e0181-2021. https://doi.org/10.1590/0037-8682-0181-2021

Paz, L. F. D. A., Medeiros, C. D. A., Martins, S. M., Bezerra, S. M. M. D. S., Oliveira Junior, W. D., & Silva, M. B. A. (2019). Quality of life related to health for heart failure patients. Revista Brasileira de Enfermagem, 72(suppl 2), 140–146. https://doi.org/10.1590/0034-7167-2018-0368

Pelegrino, V. M., Spadoti Dantas, R. A., Ciol, M. A., Clark, A. M., Rossi, L. A., & Simões, M. V. (2011). Health-related quality of life in Brazilian outpatients with Chagas and non-Chagas cardiomyopathy. Heart & Lung, 40(3), e25–e31. https://doi.org/10.1016/j.hrtlng.2010.05.052

Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [free ebook]. Santa Maria. Editora da UFSM.

Quintino, N. D., Sabino, E. C., da Silva, J. L. P., Ribeiro, A. L. P., Ferreira, A. M., Davi, G. L., Oliveira, C. D. L., & Cardoso, C. S. (2020). Factors associated with quality of life in patients with Chagas disease: SaMi-Trop project. PLOS Neglected Tropical Diseases, 14(5), e0008144. https://doi.org/10.1371/journal.pntd.0008144

Ritt, L. E., Carvalho, A. C., Feitosa, G. S., Pinho-Filho, J. A., Andrade, M. V. S., Feitosa-Filho, G. S., Newby, L. K., & Lopes, R. D. (2013). Cardiopulmonary exercise and 6-min walk tests as predictors of quality of life and long-term mortality among patients with heart failure due to Chagas disease. Int. J. Cardiol, 168(4), 4584–4585. https://doi.org/10.1016/j.ijcard.2013.06.064

Santos-Filho, J. C. L., Vieira, M. C., Xavier, I. G. G., Maciel, E. R., Rodrigues Junior, L. F., Curvo, E. O. V., Pereira, I. M., Quintana, M. S. B., Sperandio da Silva, G. M., Veloso, H. H., Mendes, F. S. N. S., Hasslocher-Moreno, A. M., Sousa, A. S., do Brasil, P. E. A. A., Saraiva, R. M., & Mediano, M. F. F. (2018). Quality of life and associated factors in patients with chronic Chagas disease. Tropical Medicine & International Health, 23(11), 1213–1222. https://doi.org/10.1111/tmi.13144

Shitsuka, R. et al. (2014). Matemática fundamental para a tecnologia. (2nd ed.). Editora Érica

Silva, P. C., De Almeida Neto, O. P., & Resende, E. S. (2021). Epidemiological profile, cardiopulmonary fitness and health-related quality of life of patients with heart failure: A longitudinal study. Health Qual Life Outcomes, 19(1), 129. https://doi.org/10.1186/s12955-020-01634-3

Silva, W. T., Ávila, M. R., Oliveira, L. F. F. de, Figueiredo, P. H. S., Lima, V. P., Bastone, A. de C., Costa, F. S. M., Mediano, M. F. F., Costa, H. S., & Rocha, M. O. C. (2020). Prevalence and determinants of depressive symptoms in patients with Chagas cardiomyopathy and predominantly preserved cardiac function. Rev. Soc. Bras. Med. Trop., 53, e20200123. https://doi.org/10.1590/0037-8682-0123-2020

Snyder, C. R., Lopez, S. J., Edwards, L. M., & Marques, S. C. (2021). The Oxford handbook of positive psychology (3nd edition). Oxford University Press.

Sousa, G. R., Costa, H. S., Souza, A. C., Nunes, M. C. P., Lima, M. M. O., & Rocha, M. O. C. (2015). Health-related quality of life in patients with Chagas disease: A review of the evidence. Revista da Sociedade Brasileira de Medicina Tropical, 48(2), 121–128. https://doi.org/10.1590/0037-8682-0244-2014

Souza, A. C. D., Rocha, M. O. D. C., Teixeira, A. L., Dias Júnior, J. O., Sousa, L. A. P. D., & Nunes, M. C. P. (2013). Depressive symptoms and disability in chagasic stroke patients: Impact on functionality and quality of life. J. Neurol. Sci, 324(1–2), 34–37. https://doi.org/10.1016/j.jns.2012.09.022

Spadaro, A. G., Bocchi, E. A., Souza, G. E., Filho, A. E., Mariani, J., Campos, C. M., & Lemos, P. A. (2019). Renal denervation in patients with heart failure secondary to Chagas’ disease: A pilot randomized controlled trial. Catheterization and Cardiovascular Interventions, 94(4), 644–650. https://doi.org/10.1002/ccd.28393

Tavares, P. A., Oliveira, C. D. L., Ferreira, A. M., Baldoni, N. R., Quintino, N. D., Haikal, D. S., Bierrenbach, A. L., Ribeiro, A. L. P., Sabino, E. C., & Cardoso, C. S. (2023). Evaluation of the properties of WHODAS-12 measurements in individuals with Chagas disease in Brazil. Revista do Instituto de Medicina Tropical de São Paulo, 65, e30. https://doi.org/10.1590/s1678-9946202365030

Trindade, A. F. V., Silva, W. T., Lima, V. P., Mendonça, V. A., Lacerda, A. C. R., Ávila, M. R., De Oliveira, L. F. F., De Almeida, I. L. G. I., Silva, K. L. S., De Oliveira, L. F. L., Carvalho, L. M. S., Da Cruz Ferreira, P. H., De Faria, S. C. C., Mediano, M. F. F., Figueiredo, P. H. S., & Costa, H. S. (2024). Assessment of health‐related quality of life in patients with Chagas cardiomyopathy using Minnesota living with heart failure questionnaire: A validation study. Tropical Med Int Health, 29(1), 6–12. https://doi.org/10.1111/tmi.13944

Vilas-Boas, F., Feitos, G. S., Soares, M. B. P., Mota, A., Pinho-Filho, J. A., Almeida, A. J. G., Andrade, M. V., Carvalho, H. G., Dourado-Oliveira, A., & Ribeiro-dos-Santos, R. (2006). Early Results of Bone Marrow Cell Transplantation to the Myocardium of Patients with Heart Failure due to Chagas Disease. Arq. Bras. Cardiol., 87(2). https://doi.org/10.1590/S0066-782X2006001500014

WHO. (2024). Chagas disease (also known as American trypanosomiasis). https://www.who.int/news-room/fact-sheets/detail/chagas-disease-(american-trypanosomiasis)

Zanon, C., & Hutz, C. (2011). Escala de afetos positivos e afetos negativos (PANAS). In C. S. Hutz (1 Ed.), Avaliação em psicologia positiva. Artmed Editora.

Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

Downloads

Published

2025-07-28

Issue

Section

Review Article

How to Cite

Depression, quality of life, subjective well-being, and psychometric assessments in Brazilian patients with Chagas disease: A literature review. Research, Society and Development, [S. l.], v. 14, n. 7, p. e8514749284, 2025. DOI: 10.33448/rsd-v14i7.49284. Disponível em: https://www.rsdjournal.org/rsd/article/view/49284. Acesso em: 15 dec. 2025.