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

英文中文

Clinical experience of electroconvulsive therapy with anaesthetic and muscle relaxant at the Clínica Universidad de La Sabana: 2009–2017 2009-2017年在Clínica萨巴纳大学进行麻醉和肌肉松弛剂电痉挛治疗的临床经验

Revista Colombiana de psiquiatria (English ed.)

Pub Date : 2023-04-01 DOI: 10.1016/j.rcpeng.2021.01.004

Ángela Rocío Acero González , Yahira Rossini Guzmán Sabogal , Hollman Salamanca Dimas , Verónica Páez Avendaño , Erika Pineda Carrascal , Juliana Izquierdo Polanco , Alejandra Ayala Escudero

Introduction

Electroconvulsive therapy is an effective and safe procedure, which is indicated mainly in patients with both unipolar and bipolar depressive episodes, mania and schizophrenia, when they do not respond to other treatments.

Objective

To describe the demographic, social and clinical properties of a group of patients treated with electroconvulsive therapy (ECT) with anaesthetic and muscular relaxant at the Universidad de La Sabana Clinic for a period of 8 years.

Methods

The databases and records of the procedures were reviewed from 1 January 2009 to 31 December 2017. An analysis was performed with descriptive statistics.

Results

In this period, 1322 procedures were performed on 143 patients (54.5% women) with an associated diagnosis of major depression in 57%. The number of treatments per person was 9.2 and complications occurred in 3.8%, without any of them requiring invasive management.

Conclusions

Electroconvulsive therapy is performed safely in patients and with different parameters in terms of age, gender and diagnosis, in comparison to other countries in Latin America and the world. It is important to join efforts in research that allow a more complete overview of the characteristics of its application in the country.

引言电休克治疗是一种有效、安全的治疗方法，主要适用于单相和双相抑郁发作、躁狂和精神分裂症患者，当他们对其他治疗没有反应时。目的描述一组在拉萨巴纳大学诊所接受为期8年的麻醉和肌肉松弛剂电休克治疗（ECT）的患者的人口统计学、社会学和临床特征。方法对2009年1月1日至2017年12月31日的手术数据库和记录进行审查。采用描述性统计进行分析。结果在此期间，对143名患者（54.5%的女性）进行了1322次手术，57%的患者被诊断为重度抑郁症。人均治疗次数为9.2次，并发症发生率为3.8%，无需任何侵入性治疗。结论与拉丁美洲和世界其他国家相比，电痉挛治疗在年龄、性别和诊断方面具有不同参数的患者中是安全的。重要的是要共同努力进行研究，以便更全面地了解其在该国的应用特点。

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引用次数: 1

Hepatoxicity induced by clozapine: Case report and brief review 氯氮平致肝毒性:病例报告及简要回顾

Revista Colombiana de psiquiatria (English ed.)

Pub Date : 2023-04-01 DOI: 10.1016/j.rcpeng.2021.04.005

Joshep Revilla-Zúñiga , Joise Cornejo-Del Carpio , Lizardo Cruzado

Introduction

Antipsychotics are drugs that can produce transient elevations of hepatic enzymes. Clozapine is an atypical antipsychotic used in treatment-resistant schizophrenia and there is evidence that it can produce elevations of hepatic transaminases, expression of liver damage in a hepatocellular pattern.

Methods

Case report and non-systematic review of the relevant literature.

Case presentation

A 39-year-old woman with a diagnosis of paranoid schizophrenia attended the emergency department of a general hospital for nausea, vomiting and jaundice that appeared after the initiation of clozapine. There was no clinical improvement during hospitalisation, and death occurred after 44 days.

Literature review

Clozapine can increase the liver enzyme levels transiently and asymptomatically; however, there are clinical criteria that recommend the withdrawal of the antipsychotic.

Conclusions

This is the third case reported in the literature of a fatal outcome of clozapine-induced hepatotoxicity.

引言抗精神病药物是一种能产生肝酶瞬时升高的药物。氯氮平是一种非典型的抗精神病药物，用于治疗难治性精神分裂症，有证据表明它可以引起肝转氨酶升高，即肝细胞模式中肝损伤的表达。方法采用病例报告和非系统查阅相关文献的方法。病例介绍：一名39岁的女性被诊断为偏执性精神分裂症，因服用氯氮平后出现恶心、呕吐和黄疸而到综合医院急诊科就诊。住院期间没有任何临床改善，44天后死亡。文献综述氯氮平能瞬时无症状地提高肝酶水平；然而，有临床标准建议停用抗精神病药物。结论这是文献中报道的第三例氯氮平肝毒性致死的病例。

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引用次数: 0

Imposter syndrome and its associated factors in medical students in six Peruvian faculties 秘鲁六个学院医学院学生的冒名顶替综合症及其相关因素

Revista Colombiana de psiquiatria (English ed.)

Pub Date : 2023-04-01 DOI: 10.1016/j.rcpeng.2021.04.006

Jennifer Vilchez-Cornejo , Luccio Romani , Saraí Chávez-Bustamante , César Copaja-Corzo , Juan C. Sánchez-Vicente , Ronald David Viera-Morón , Benggi Ocampo-Portocarrero

Objective

To determine the factors associated with impostor syndrome in medical students from six regions of Peru.

Material and methods

A multicentre, cross-sectional study was conduced on students from first to the sixth year in six Peruvian regions. Sociodemographic, academic, and psychological characteristics were included through the Depression, Anxiety, and Stress Scale-21, the Rosenberg Self-Esteem Scale and the Clance Imposter Phenomenon Scale. Generalised linear models were performed using crude and adjusted estimated prevalence ratios.

Results

Of 2,231 medical students, 54.3% were female and 30.6% had the impostor phenomenon. An association was found between the PI and those who suffered from depression (aPR = 1.51; 95%CI, 1.27–1.79), anxiety (aPR = 2.25; 95%CI, 1.75–2.90), stress (aPR = 1.37; 95%CI, 1.19–1.57), and being female (aPR = 1.12; 95%CI, 1.01–1.26).

Conclusions

Three out of 10 medical students suffer from PI; having some level of depression, anxiety, stress, being a woman, and/or attending the fourth academic year were predisposing factors for their development.

目的确定秘鲁六个地区医学生冒名顶替综合征的相关因素。材料和方法对秘鲁六个区域的一至六年级学生进行了一项多中心的横断面研究。通过抑郁、焦虑和压力量表-21、Rosenberg自尊量表和Clance Imposter现象量表包括社会形态、学术和心理特征。使用粗略和调整后的估计患病率进行了广义线性模型。结果2231名医学生中，女性占54.3%，有冒名顶替现象的占30.6%。PI与患有抑郁症（aPR=1.51；95%CI，1.27-1.79）、焦虑症（aPR=2.25；95%可信区间，1.75-2.90）、压力症（aPR=1.37；95%置信区间，1.19-1.57）和女性（aPR=1.12；95%可信范围，1.01-1.26）的人之间存在关联。结论十分之三的医学生患有PI；有一定程度的抑郁、焦虑、压力、身为女性和/或参加第四学年是他们发展的诱发因素。

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引用次数: 0

Repercussions of COVID-19 on psychiatric inpatient care in Latin America and the Caribbean COVID-19对拉丁美洲和加勒比地区精神科住院治疗的影响

Revista Colombiana de psiquiatria (English ed.)

Pub Date : 2023-01-01 DOI: 10.1016/j.rcpeng.2021.05.005

Sara Ardila-Gómez , Marina Fernández , Andrés Matkovich , Melina Rosales , Rocío Alonso , Martín Agrest , Julia Paternina , Alberto Velzi Díaz

Objetive

To characterise the impact of the COVID-19 pandemic on psychiatric hospitalisations in the Latin American and Caribbean (LAC) region.

Methods

Descriptive study. 85 semi-structured interviews were conducted with health workers involved with psychiatric hospitalisations in general hospitals (GHs) and specialised psychiatric hospitals (SHs) from 18 LAC countries. The interviews were done between 8 May and 30 June 2020. The data were analysed quantitatively and qualitatively.

Results

An initial decrease in the demand for hospitalisation is reported, attributed to the population’s fear of approaching health services as well as restrictions on mobility. Stricter criteria for hospitalisation were reported with a double focus on the acute within the acute. The length of hospitalisations were mixed, with both increases and decreases in GHs and SHs. The therapeutic offer was drastically reduced, and interaction between hospitalised people and their support networks was restricted.

Conclusions

In the COVID-19 context, hospitalisation seems to be not the last but the only alternative for psychiatric treatment. The decrease in the number of beds in SHs could be a positive aspect for the reform of psychiatric care, but it is questioned since this reduction also occurs in GHs.

目的分析2019冠状病毒病大流行对拉丁美洲和加勒比地区精神科住院的影响。MethodsDescriptive研究。对来自18个拉丁美洲和加勒比地区国家的综合医院和专科精神病医院从事精神病住院治疗的卫生工作者进行了85次半结构化访谈。访谈于2020年5月8日至6月30日期间进行。对数据进行定量和定性分析。结果据报告，住院需求最初有所下降，原因是人们害怕接近卫生服务机构，以及行动受到限制。报告了更严格的住院标准，并将双重重点放在急症中的急症上。住院时间长短不一，GHs和SHs有增有减。治疗服务大幅减少，住院患者与其支持网络之间的互动受到限制。结论在COVID-19背景下，住院治疗似乎不是最后的选择，而是唯一的选择。精神病院床位数量的减少可能是精神科护理改革的一个积极方面，但由于这种减少也发生在家庭医院，因此值得质疑。

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引用次数: 1

Prevalence and clinical characteristics of depression and symptoms of anxiety in staff at a health institution in Medellin during the COVID-19 pandemic 2019冠状病毒病大流行期间麦德林一家卫生机构工作人员抑郁和焦虑症状的患病率和临床特征

Revista Colombiana de psiquiatria (English ed.)

Pub Date : 2023-01-01 DOI: 10.1016/j.rcpeng.2021.02.005

Miguel Restrepo-Martínez , Marcela Escobar , Luz Aida Marín , Diana Restrepo

Introduction

The COVID-19 pandemic has represented an extraordinary challenge for health workers as they care for others while exposing themselves to contagion. Doctors, nurses, therapists and other non-care staff in clinics and hospitals are asked to be prepared to work in particularly complex and stressful situations, which makes them vulnerable to mental health problems.

Objective

To determine the prevalence and clinical characteristics of anxiety and depression symptoms in staff working at a health institution in Medellin, Colombia.

Methods

Observational, descriptive and cross-sectional study, based on a survey designed for the investigation, which included two scales to screen depression and anxiety symptoms, as well as sociodemographic variables.

Results

A total of 1,247 workers from the health institution were included. Of these, 14.6% reported symptoms of depression and 18.5% of clinically significant anxiety. A higher proportion of moderate to severe depression and anxiety symptoms was found in those working face to face.

Conclusions

Anxiety and depression symptoms are highly prevalent among staff at a health institution in Medellin, Colombia, during the COVID-19 pandemic. Given the vital role of the health sector in times of pandemic, the development of mental health programmes that address the problems of this population should be considered a priority.

2019冠状病毒病大流行给卫生工作者带来了巨大挑战，因为他们在照顾他人的同时，自己也面临着感染风险。要求诊所和医院的医生、护士、治疗师和其他非护理人员做好在特别复杂和紧张的情况下工作的准备，这使他们容易出现精神健康问题。目的了解哥伦比亚麦德林市某卫生机构工作人员焦虑和抑郁症状的患病率及临床特征。方法采用观察性、描述性和横断面研究，基于为调查设计的调查，其中包括筛选抑郁和焦虑症状的两个量表，以及社会人口学变量。结果共纳入该卫生机构工作人员1247人。其中，14.6%的人报告有抑郁症状，18.5%的人有临床显著的焦虑。面对面工作的人出现中度至重度抑郁和焦虑症状的比例更高。结论2019冠状病毒病大流行期间，哥伦比亚麦德林一家卫生机构的工作人员普遍存在焦虑和抑郁症状。鉴于卫生部门在大流行病期间的重要作用，应将制定解决这一人群问题的精神卫生方案视为优先事项。

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引用次数: 0

Network relationships of the stigma-discrimination complex and fear of COVID-19 during the second pandemic wave in Peruvian adults 第二波大流行期间秘鲁成年人的污名歧视情结和对COVID-19的恐惧的网络关系

Revista Colombiana de psiquiatria (English ed.)

Pub Date : 2023-01-01 DOI: 10.1016/j.rcpeng.2023.03.005

Cristian Ramos-Vera

引用次数: 0

The right to die with dignity through euthanasia, six years on 六年后，通过安乐死有尊严地死去的权利

Revista Colombiana de psiquiatria (English ed.)

Pub Date : 2023-01-01 DOI: 10.1016/j.rcpeng.2023.03.003

Clara Cossio-Uribe, Julieta Moreno-Molina

引用次数: 0

Antisocial traits and neuroticism as predictors of suicidal behaviour in borderline personality disorder: A retrospective study 反社会特征和神经质作为边缘型人格障碍自杀行为的预测因素:一项回顾性研究

Revista Colombiana de psiquiatria (English ed.)

Pub Date : 2023-01-01 DOI: 10.1016/j.rcpeng.2023.03.002

Íñigo Alberdi-Páramo , Marina Díaz-Marsá , María Dolores Saiz González , José Luis Carrasco Perera

Introduction

The spectrum of suicidal behaviour (SB) is nuclear in the clinic and management of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB.

Methods

A cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman–Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the χ² test and the Student’s t-test. The association between variables was analysed using multivariate logistic regression.

Results

Statistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman–Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman–Kuhlman and Barrat tests does not appear to be related to SB.

Conclusions

The results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings.

自杀行为谱(SB)在边缘型人格障碍(BPD)的临床和治疗中具有重要意义。BPD的病理人格特征与其他与BPD相关的临床和社会人口学变量共同干预SB的危险因素。方法对134例按照DSM-5标准诊断为BPD的患者进行横断面、观察性和回顾性研究。使用Millon-II、Zuckerman-Kuhlman和Barrat问卷来评估不同的人格参数。变量比较采用χ2检验和学生t检验。采用多元逻辑回归分析变量间的相关性。结果在Zuckerman-Kuhlman测验中，SB及其相关因素与神经质焦虑维度存在显著差异。它也与百万级ii的恐惧和反社会子量表显著相关。用Zuckerman-Kuhlman和Barrat测试测量的冲动性似乎与SB无关。结论提出了恐惧、反社会和神经质特征作为与SB相关的BPD可能的人格特征的作用，表明BPD与SB之间的关系比冲动性更重要。展望未来，纵向研究将为特定的发现增加科学证据。

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引用次数: 1

A journal for the regional challenges of psychiatry but with a global voice 一本关于精神病学区域性挑战的杂志，但具有全球性的声音

Revista Colombiana de psiquiatria (English ed.)

Pub Date : 2023-01-01 DOI: 10.1016/j.rcpeng.2023.04.001

Hernando Santamaría-García

引用次数: 0

Educational environment and mental wellbeing of medical and surgical postgraduate residents in Medellin, Colombia 哥伦比亚麦德林医疗和外科研究生住院医师的教育环境和心理健康

Revista Colombiana de psiquiatria (English ed.)

Pub Date : 2023-01-01 DOI: 10.1016/j.rcpeng.2021.02.006

María Adelaida Posada Uribe , Verónica Vargas González , Clara Orrego Morales , Carolina Cataño , Elsa María Vásquez , Diana Restrepo

Introduction

One of the most important moments in a doctor’s life occurs when they do a medical residency. This period imposes stress and academic demands, which, together with the educational environment, allows for greater or lesser mental wellbeing. The objective of this study was to determine how the educational environment and mental wellbeing of medical residents are related.

Methods

Analytical cross-sectional study, in residents of clinical-surgical specialties. The educational environment was assessed using the Postgraduate Hospital Educational Environment Measure (PHEEM), and mental wellbeing was assessed with the Warwick–Edinburgh Mental Wellbeing Scale (WEMWBS). Pearson’s linear correlation was determined. Informed consent and approval by the university ethics committee were obtained.

Results

The study population comprised 131 students, 43.8% male, with a median age of 28 years (interquartile range 4). In total, 87.9% of residents answered the survey. Of these, 65.9% were doing medical residencies and 34.1% surgical residencies. The mean PHEEM score was 107.96 ± 18.88, the positive emotions subscale was 29.32 ± 5.18 and positive functioning 23.61 ± 3.57, with a mean total mental wellbeing of 52.96 ± 8.44. A positive and moderate correlation was found between the total PHEEM score and each of the two mental wellbeing subscales (p < 0.001).

Conclusions

A positive correlation was found between a better perception of the educational environment and mental wellbeing by residents of clinical and surgical specialties with greater mental wellbeing.

医生一生中最重要的时刻之一发生在他们做住院医生的时候。这一时期的压力和学业要求，加上教育环境，使心理健康或多或少。本研究旨在探讨教育环境与住院医师心理健康的关系。方法对临床外科专科住院医师进行横断面分析研究。采用研究生医院教育环境量表(PHEEM)评估教育环境，采用沃里克-爱丁堡心理健康量表(WEMWBS)评估心理健康。Pearson线性相关测定。获得了学校伦理委员会的知情同意和批准。结果研究对象为学生131人，其中男性43.8%，年龄中位数28岁(四分位差4)，总应答率为87.9%。其中65.9%是内科住院医师，34.1%是外科住院医师。平均PHEEM得分为107.96 ± 18.88，积极情绪得分为29.32 ± 5.18，积极功能得分为23.61 ± 3.57，总心理健康得分为52.96 ± 8.44。PHEEM总分与两个心理健康亚量表均存在正相关和中度相关(p < 0.001)。结论心理幸福感较高的临床和外科专科住院医师对教育环境的感知与心理幸福感呈正相关。

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