Revista Colombiana de Psiquiatria最新文献

Introduction

The new COVID-19 disease is worldwide. During the pandemic, attacks on healthcare staff have increased. The objective of the study was to know the incidence of aggression towards nursing staff and to evaluate the main emotional and psychological symptoms experienced during the COVID-19 pandemic in Latin America.

Method

A cross-sectional survey was applied to nursing staff of Spanish-speaking Latin American countries. Sociodemographic information was obtained concerning aggression, psychological symptoms, and emotional state. Descriptive statistics were applied in frequencies and percentages, means and standard deviation.

Results

310 people from Mexico (65.2%), Argentina (5.8%), Colombia (5.2%), Honduras (5.2%), Costa Rica (4.5%) and other Latin American countries (14.1%) participated. 78.1% were women, with an average age of 35.2 years. 79.6% of the sample reported being attacked or discriminated against. The most common emotions were fear of getting sick (73.7%), sleep disturbances (33.4%), fear of infecting their relatives (33.4%). The mental health disorders reported were anxiety (29.2%), sadness (10.4%) and increased appetite (8.8%). The most frequent locations of aggression were the street and public transport.

Conclusions

Our results suggest a high incidence of aggression against nursing staff during the pandemic; in any case, the staff present emotional and mental disturbances. It is necessary to develop safety and security policies for nursing staff and provide mental health care to staff who are on the first line of defence against COVID-19.

Introduction

The Beck Depression Inventory-II (BDI-II) is one of the most frequently used instruments in clinical and research practice for depression symptoms. However, its psychometric properties in the Colombian population are unknown. The objective of this study was to find evidence of these properties in university students, who have a high prevalence of depression.

Method

An instrumental study was carried out to evaluate the reliability, and to know the evidence of validity of the internal structure and the relationship with other variables of the BDI-II in a sample of 409 students of a private university in Bogotá.

Results

Regarding reliability, a Cronbach's alpha = 0.91 was obtained. As evidence of validity, item-test correlations were found that ranged from 0.31 to 0.67, all of them statistically significant (P< 0.0001) and a good fit of a bifactorial model (RMSEA = 0.040; SRMR = 0.046; CFI = 0.984; TLI = 0.981) and of a second-order model to the data. (RMSEA = 0.045; SRMR = 0.045; CFI = 0.978; TLI = 0.975). In relation to other variables, a direct and statistically significant correlation was found with risk factors (=0.65) and inverse with the protective factors (=–0.519) of the Positive and Negative Suicide Ideation Inventory (PANSI).

Conclusions

This evidence indicates that the BDI-II scores obtained enable depression symptoms to be inferred in this population and its clinical and research use is recommended. However, more confirmatory studies are needed in populations with greater variability.

Objective

To characterise community mental health consultations in a primary care centre in Cali, Colombia.

Methods

Observational, descriptive, cross-sectional study. A secondary database was used, systematically recording patients seen in the community outpatient clinic, and a description of the information recorded therein was prepared. All the records available in the database were used. The data were processed using Microsoft Excel and the program SPSS 25 was used for the statistical analysis.

Results

481 consultations were conducted, of which 272 were first time consultations; in total 383 patients were seen, which indicates that 1.26 consultations were carried out per patient. The average age of the patients who consulted was 43.5 ± 21.7 years. Sixty-one point five percent of the consultations were for women, while adulthood was the stage of life in which the highest percentage (51.8%) attended. The most common socioeconomic stratum was 1, which indicates that this institution serves above all the low-income population.

Conclusions

The results of this study allowed us to recognise the main reasons for consultation in the community mental health service, a necessary input to design and develop preventive programmes that promote and strengthen community-based rehabilitation strategies.

Introduction

The hospitalisation of patients with anorexia nervosa poses an important bioethical quandary and can generate stress for the healthcare professionals. Our goal was to know and analyse the opinion of mental health professionals on some conditions for applying the involuntary hospitalisation of patients with anorexia nervosa.

Methods

Cross-sectional descriptive observational study on a sample of 270 mental health professionals, using an ad hoc questionnaire with scores ranging from 0 to 10.

Results

The professionals state that, in some cases, the patient accepts admission reluctantly: 7.74 (95% CI, 7.55-7.93). In the event of physical risk, it is difficult for them to combine respect for the patient's autonomy and the duty of care: 6.06 (95% CI, 5.70-6.41) and the relationship with the patient is largely oriented to convince them: 7.18 (95% CI, 6.91-7.46). They do not decide on the suitability of the participation of non-medical staff in the decision: 5.13 (95% CI, 4.75-5.52), or if the indication should correspond to someone other than the doctor in charge of their care: 4.79 (95% CI, 4.39-5.19). They reject the possibility of conscientious objection: 4.05 (95% CI, 3.68-4.41).

Conclusions

Mental health professionals are subject to ambiguous work demands, which affects their care dynamics.

Introduction and objectives

Machismo is a deeply rooted problem in Latin American society, but this has not been measured in the context of future health professionals. The objective was to identify factors associated with machismo among medical students from eight cities in five Latin American countries.

Methods

An analytical cross-sectional multicentre study was conducted. A total of 2,468 students of human medicine in five Latin American countries were surveyed. Machismo was measured with a validated scale (α = 0.89) and cross-checked against other important social and educational variables. Analytical statistics were derived from generalised linear models.

Results

According to the multivariate analysis, machismo occurred at the highest rate among men (prevalence ratio [PR] 1.68; 95% CI 1.29-2.21; p < 0.001) and at an older age (PR 1.02; 95% CI 1.01-1.02; p < 0.001), whereas it occurred at lower rates at a higher level of academic study (PR 0.96; 95% CI 0.91-0.99; p = 0.043) and among those who claimed to belong to an evangelical religion (PR 0.86; 95% CI 0.76-0.98; p = 0.022). Compared to students from Asunción, those from Bogotá had a higher rate of machismo adjusted for three variables (PR 1.26; 95% CI, 1.19-1.34; p < 0.001) than those from Quito (PR 1.14; 95% CI, 1.06-1.22; p < 0.001), those from Panama City (PR 1.19; 95% CI, 1.16-1.21; p < 0.001), those from Ciudad del Este (PR 1.50; 95% CI, 1.34-1.68; p < 0.001), those from Mérida (PR 1.42; 95% CI, 1.37-1.49; p < 0.001) and those from Carabobo (PR 1.60; 95% CI, 1.52-1.68; p < 0.001); however, those from Bolívar had less machismo (PR 0.58; 95% CI, 0.51-0.66; p < 0.001).

Conclusions

Factors significantly associated with machismo were found among medical the students studied; the most important ones were sex, age, academic year, religion and country of residence.

Although delusions are regarded as the mark of psychosis, their observation in clinical contexts still leads to a number of empirical and conceptual debates. In this context, the typology debate tries to answer the question about the specific type of mental state instantiated by delusional beliefs. Answers to this debate are fundamental, particularly in terms of guiding empirical research on the aetiology and treatment of delusions. This article explores three approaches to this discussion. After examining all the strengths and weaknesses, suggestions are made about how these approaches – commonly depicted as rivals in current literature – might work together to gain a more complex, fruitful, and contextualised understanding of delusions in the context of psychosis.

Objective

To evaluate rates of anxiety, depression and stress, as well as associated factors and changes in habits, among students of human medicine from the Universidad Nacional San Cristóbal de Huamanga [San Cristóbal of Huamanga University] (UNSCH), located in Ayacucho (Peru), in the context of the COVID-19 pandemic.

Methods

A cross-sectional study was conducted through a virtual survey. The Depression Anxiety Stress Scale-21 (DASS-21) was used. To evaluate associated factors, prevalence ratios (PR) were estimated using Poisson regression with robust variance.

Results

A total of 284 surveys were analysed (48.2% women; median age 22 years). Rates of (at least moderate) depression, anxiety and stress were 24.3%, 28.5% and 13.0%, respectively. Adjusted analyses found that having completed fewer years of study, being Catholic and having a chronic disease were associated with a higher rate of anxiety, while being of a younger age was associated with a higher rate of stress. The students reported mostly decreased physical activity, as well as increased Internet and social media use, hours of sleep, hours spent in front of a screen, food intake, and weight, during the COVID-19 pandemic.

Conclusions

In the context of the pandemic, despite the changes in habits described, rates of depression, anxiety and stress were lower than in previous studies in students in the health sciences. The higher rate of anxiety was associated with being in an earlier academic year, Catholicism and chronic diseases, while the higher rate of stress was associated with being of a younger age.

Introduction

The study of behaviour is a fundamental part of comprehensive patient care, since the patient should be considered as a biopsychosocial entity. In the case of Alzheimer's disease (AD), the major limitation in the diagnosis of the patient is that it can only be made after death. Therefore, identification of behaviours consistent with behavioural dysfunction, psychosis and neuropsychiatric symptoms represents a very useful tool for establishing a presumptive diagnosis in vivo of AD. Further taking into account that diabetes mellitus (DM) is a disease with a growing worldwide incidence that is considered a risk factor for the development of AD, the presence of depressive behaviours and mild cognitive impairment stand out as important elements identified in the DM/AD link.

Results

This study presents the results of a review of evidence obtained from secondary sources and describes characteristic behaviours identified in AD.

Conclusions

We conclude that the depressive behaviour identified in both AD and MD and the analysis of depressive behaviours along with mild cognitive impairment are part of the link between DM and AD.

Background and objectives

Mental illnesses can affect an individual's decision-making capacity, forcing family members to make decisions about treatment. Cultural variations in preferences and degree of participation in care have been reported. The objective was to identify and characterise opinions, preferences concerning participation and decision-making methods regarding treatment among relatives of patients with mental illnesses treated in mental health institutions in Bogotá, Colombia.

Methods

A qualitative focus-group study with 37 adult relatives of patients with mental illness seen in two psychiatric clinics and discourse analysis on decision-making based on constructivist grounded theory.

Results

Four initial categories consistent with the literature, as well as a new culturally relevant category that emerged, called “companionship”, are presented. The initial deductive categories described are: companionship, tools, method, symptoms and treatment. Specific and exclusive themes were derived that resulted in 31 final emerging subcategories. Family members were seen to want to actively participate in the decision-making process along with the psychiatrist and the patient, but to face some specific difficulties in relation to mental illness making it difficult for them to act as efficient caregivers. A systemic scheme on the interaction of the categories in decision-making is proposed.

Conclusions

Family members of individuals with mental illness seek to participate in clinical decision-making with affection, responsibility and intuition, in a collaborative relationship with the psychiatrist and the institution in charge of their treatment.