Revista Colombiana de psiquiatria (English ed.)最新文献

Objective

To determine the psychiatric diagnoses and treatments of patients admitted to the high-risk obstetric service who underwent a consultation with a liaison psychiatrist.

Methods

A descriptive observational study that included pregnant women from the high-risk obstetric service of a highly specialised clinic in Medellín, who had a liaison psychiatry consultation between 2013 and 2017. The main variables of interest were psychiatric and obstetric diagnoses and treatments, in addition to biopsychosocial risk factors.

Results

A total of 361 medical records were screened, with 248 patients meeting the inclusion criteria. The main prevailing psychiatric diagnosis was major depressive disorder (29%), followed by adaptive disorder (21.8%) and anxiety disorders (12.5%). The pharmacologic treatments most used by the psychiatry service were SSRI antidepressants (24.2%), trazodone (6.8%) and benzodiazepines (5.2%). The most common primary obstetric diagnosis was spontaneous delivery (46.4%), and the predominant secondary obstetric diagnoses were hypertensive disorder associated with pregnancy (10.4%), gestational diabetes (9.2%) and recurrent abortions (6.4%). Overall, 71.8% of the patients had a high biopsychosocial risk.

Conclusions

The studied population's primary psychiatric disorders were major depressive disorder, adjustment disorder and anxiety disorders, which implies the importance of timely recognition of the symptoms of these perinatal mental pathologies, together with obstetric and social risks, in the prenatal consultation. Psychiatric intervention should be encouraged considering the negative implications of high biopsychosocial risk in both mothers and children.

This research aims to determine the relationship between the variables adaptation to the disease, resilience and dispositional optimism in women with breast cancer in Montería (Colombia). This study is a descriptive-correlational type, evaluating 116 participants. The instruments applied were the Font Quality of Life Questionnaire, to assess the Index of Adaptation to Disease, Wagnild and Young’s Resilience Scale (RS) and the Life Orientation Test-Revised (LOT-R). The statistical program SPSS 25.0 was used for the analysis of the data. A normality test was performed which led to the application of the Spearman correlation coefficient. Findings indicated the presence of adaptation in the participants and resilient and optimistic characteristics, however, there is no significant relationship between these variables and adaptation to the disease.

The objective of the study is to understand the experience of grief and moral sentiments in survivors of the armed conflict in the city of Medellín, Colombia, through qualitative research. In total, 32 people affected by different victimising acts in the context of the armed conflict participated. There is a direct relationship between moral sentiments and the processes of handling and processing loss. Moral sentiments frame the experience of emotions in the victim, after the events have occurred, which influence the way in which the pain experienced is processed. These sentiments permeate the processes of dealing with the incident in survivors, the ways in which they perceive themselves and the perpetrators, and the social stances they adopt to face life. We conclude that moral factors play a role in the emotional recovery of victims and are indicative the possibility or difficulty of processing the events that occurred.

Introduction

Mild cognitive impairment produces slight cognitive and motor disturbances without affecting daily life during aging, however, if this symptomatology is not controlled, the speed of deterioration can increase, and even some cases of dementia can appear in the elderly population.

Objective

To describe non-pharmacological therapies that seek to prevent, control and reduce the symptoms of mild cognitive impairment.

Methods

An initial search was carried out in the databases of PubMed, Lilacs, EBSCO, ScienceDirect, Taylor & Francis and ProQuest. The results found were filtered through the PRISMA system and biases evaluated using the Cochrane Handbook for Systematic Reviews of Interventions.

Results

Four categories of non-pharmacological therapies were created, using 50 articles found in the search, which contribute to controlling and improving cognitive and motor areas, in order to reduce the symptoms presented by mild cognitive impairment. The treatments have different methods, instruments and objectives, so that no meta-analysis of the studies could be performed. In addition, limitations related to the sample, the effectiveness of the results and the methodological quality were found.

Conclusions

It was found that non-pharmacological therapies prevent, improve and control the symptoms caused by mild cognitive impairment, however, it is necessary to carry out more studies with better methodologies to corroborate these results.

Introduction and objectives

Burnout syndrome (BS) has been evaluated in few populations of medical students, and its relationship with depression is even less studied. The objective was to determine the frequency of BS in medical students of the Universidad Pedagógica y Tecnológica de Colombia (UPTC), in Tunja, Colombia, as well as its association with depression and other social, economic, demographic, and academic factors.

Methods

An observational, analytical, cross-sectional study was carried out on 182 UPTC medical students during 2018. The Maslach Burnout Inventory-Student Survey (MBI-SS) was applied, with which 3 components were obtained to determine positive SB. This was crossed in the Stata 15 program for depression and other social, economic, demographic, and academic covariates with the Generalised Linear Model (GLM).

Results

Of 182 respondents, 51.4% were women. The median age was 21 years (20−23 years). 14% had BS, of which 48% had depression. In the multiple regression, BS was significantly associated with a higher frequency of depression (RPa = 5.54; IC95%, 2.36−13.02; P < 0.001) and the feeling of insufficient money (RPa = 4.37; IC95%, 1.95−9.83; P < 0.001), in contrast to a negative association with smoking (RPa = 0.13; IC95%, 0.06−0.30; P < 0.001) and being a woman (RPa = 0.32; IC95%, 0.12−0.82; P = 0.018). The age of onset of marijuana use was not significant.

Conclusions

BS shows a high association with increased depression and a feeling that the money is not enough at the end of the month, but it showed a negative association with tobacco consumption and being a woman. Such students should be detected to provide them with adequate academic support

Introduction

Mild Cognitive Impairment (MCI) is common in Parkinson's Disease (PD). Few studies have compared the Health-Related Quality of Life (HRQoL) in patients with and without MCI due to PD (PD-MCI), and its correlation to patients’ subjective cognitive and communicative difficulties has not been explored.

Objective

We aimed to compare HRQoL in PD-MCI and PD without MCI (PD-nMCI), and explore its possible relationship to subjective cognitive and communicative complaints.

Methods

We included 29 PD-nMCI and 11 PD-MCI patients. The HRQoL was assessed with the Parkinson's Disease Questionnaire-39 (PDQ-39): its Cognition dimension was used as a measure of subjective cognitive complaints, its Communication dimension for subjective communicative complaints, and the summary index (PDQ-39 SI) as an indicator of HRQoL. Non-parametric partial correlations between the Cognition and Communication dimensions, and the adjusted PDQ-39 SI were conducted.

Results

PD-MCI patients had greater subjective cognitive and communicative complaints and worse HRQoL than PD-nMCI patients. In the PD-MCI group, both subjective cognitive and communicative complaints exhibited significant direct correlations with the adjusted HRQoL scores.

Conclusions

HRQoL seems to be affected in PD-MCI, and it might be influenced by greater subjective cognitive and communicative complaints. Including patient-reported outcome measures of HRQoL, and providing cognitive and speech rehabilitation, as well as psychotherapeutic strategies to face these deficits can enhance the patient-centred approach in PD.

Introduction

The evidence regarding the effects of the Inverted Classroom on students' metacognitive skills is limited. This study evaluates these effects on student perceptions about knowledge and cognitive regulation during a surgical course.

Methods

We measured student perceptions before and after a conventional Inverted Classroom in surgery using the Metacognitive Awareness Inventory. We evaluated the mean differences between the scores of the two measurements using Student’s t-test (p < 0.05), and the size of the effect on knowledge and cognitive regulation using Cohen’s d test (95%CI).

Results

A total of 158 students (pre-intervention) and 155 students (post-intervention) were included in the analysis. Significant differences were found (p < 0.05) in, as well as positive effects on, the students’ abilities to know their own learning (declarative knowledge) (d = 0.24; 95%CI, 0.02−0.47), to use learning strategies (procedural knowledge) (d = 0.19; 95%CI, –0.02 to 0.41) and to understand when and why to use these strategies (conditional knowledge) (d = 0.20; 95%CI, –0.01 to 0.42), in addition to the abilities to plan (d = 0.31; 95%CI, 0.09−0.53) and to evaluate their learning (d = 0.31; 95%CI, 0.08−0.53).

Conclusions

The Inverted Classroom has positive effects on metacognitive skills according to students’ perceptions. Further studies are required that compare these effects with other methodologies for teaching in the classroom and the workplace.

Introduction

During the health emergency, there is concern about the mental health repercussions that Peruvian health workers, who represent the front line of care for COVID-19, may be experiencing.

Objective

To determine whether concern about COVID-19 and workloads predict psychological distress in healthcare workers.

Methods

Predictive study in which 367 workers (nurses, doctors, nursing assistants, obstetricians, dentists, psychologists, nutritionists, among others) from 12 health networks in the Puno region participated, selected through intentional non-probabilistic sampling. The data were collected via the Kessler Psychological Distress Scale, the COVID-19 Scale of Concern and the Workload Scale.

Results

It was found that there are no significant differences between men and women in psychological discomfort and concern about COVID-19 infection and workload. Furthermore, highly significant correlations were found between the study variables (P < .01). Multiple regression analysis showed an adequate adjustment for the model (F = 94.834; P < .001), where concern about COVID-19 (β = –0.436; P < .01) and workload (β = 0.239; P < .01) are variables that significantly predict psychological discomfort (adjusted R² = 0.33).

Conclusions

Concern about COVID-19 and work overload predict psychological distress in health personnel in the Puno region.

Objective

To classify the staff of two reference institutions for COVID-19 care in Antioquia according to the intensity of anxiety and depression symptoms, and to determine the factors associated with these classes.

Methods

Cross-sectional study in which the GAD-7, PHQ-9, fear of COVID-19, and the Copenhagen Burnout scale were used. Latent class analysis was performed to identify the classes, and the factors associated with these were determined using multinomial logistic regression.

Results

486 people participated. The three-class model had the best fit: class I with low scores on the scales; class II with mild degrees of anxiety and depression, and intermediate levels of fear of COVID-19 and perceived stress; and class III with moderate and severe degrees of anxiety, depression, and perceived stress. The factors associated with belonging to class III were age (OR = 0.94; 95%CI, 0.91−0.96), change of residence to avoid exposing relatives (OR = 4.01; 95%CI, 1.99–8.09), and a history of depressive disorder (OR = 3.10; 95%CI, 1.27–7.56), and anxiety (OR = 5.5; 95%CI, 2.36–12.90). Factors associated with class II were age (OR = 0.97; 95%CI, 0.95−0.99), history of depressive disorder (OR = 3.41; 95%CI, 1.60−7.25), living with someone at risk of death from COVID-19 (OR = 1.86; 95%CI, 1.19−2.91), family member being healthcare staff (OR = 1.58; 95%CI, 1.01−2.47), and change of residence to avoid exposing relatives (OR = 1.99; 95%CI, 1.11−3.59).

Conclusions

Three classes of participants were obtained, two of them with anxiety and depression symptoms. Younger age and a history of mental disorder were factors associated with the two classes of symptomatic patients; other factors may be causes or consequences of the symptoms.

Introduction

Wives of military personnel in action living on bases located in areas of armed conflict in Colombia before the peace negotiations with the Revolutionary Armed Forces of Colombia (FARC), were first-hand observers of the war, their husbands' participation in the war and the consequences and effects of the combat in which others participated.

Objective

To offer a hypothesis regarding these women's experience of direct trauma and characterise the dimensions of their experience as observers of the suffering of others.

Methods

Qualitative study and secondary discourse analysis in intentional snowball sampling of wives of military personnel (officers and chiefs) with whom semi-structured interviews were conducted.

Conclusions

Direct trauma is not the sole cause of psychosomatic and psychopathological consequences; the experience of constantly observing the suffering and deaths of others also generates a cumulative effect that can affect physical and mental health. This experience is called passive trauma.