Vertex (Buenos Aires, Argentina)最新文献

Introduction: Suicidal ideation is the thought of self-elimination that is not always reported by patients tested for depression.

Objective: The objective was to identify and analyze depressive symptoms from the Patient Health Questionnaire-9 associated with suicidal ideation in the Peruvian population.

Material and methods: Observational, analytical and cross-sectional study based on data from 32,062 participants of the national family health survey using the patient health questionnaire-9. The Chi-square test, Poisson regression with robust variance, multilayer perceptron and decision tree were used.

Results: In women, the decision tree algorithm correctly classified 91.10 % of cases of suicidal ideation. In men, it was 94.70 %. Using multilayer perceptron, in women, the percentage of incorrect predictions was 8.90 %. The variables being included: feeling bad, feeling depressed, speaking or moving slowly, problems concentrating and sleeping problems. In men it was 8.12 %, including the variables: feeling bad, feeling depressed, speaking or moving slowly, sleep problems and little or a lot of appetite.

Conclusions: Supervised learning algorithms are viable and efficient to identify depressive symptoms from the Health Questionnaire-9 associated with suicidal ideation in the Peruvian population, with somatic symptoms predominating in women and affective-cognitive symptoms in men. The use of supervised learningalgorithms can be a complement for mental health professionals.

Introduction: Depression is the most common mental health pathology. General practitioners are the most consulted health professionals by depressed patients. The inequitable distribution and shortage of psychiatrists in cities in the interior of the country mean that the coverage of the increased demand for mental health services is insufficient, and that it is up to first-level care doctors to assist patients with depressive disorders. Stigma towards psychiatry and the shortage of psychiatrists, among other factors, are common in the interior of our country. At the same time, many psychiatrists work only in the private health system.

Aim: To analyze the approach to depression by primary care physicians or first contact, whether they prescribe antidepressants and the factors which determine that prescription.

Method: A non-experimental, descriptive, cross-sectional, quantitative and qualitative study was carried out. A semi-structured questionnaire was used as a measurement instrument. The questionnaire was applied to 51 doctors, 22 clinical doctors and 29 generalists from the city of Olavarría, Argentina. In relation to the qualitative analysis, an unstructured interview was carried out.

Results and conclusions: 90.9 % of the clinical doctors and 76.6 % of the general practitioners surveyed in Olavarría treat patients experiencing a depressive episode. Many family doctors agree that the difficulty in accessing psychiatrists who do not serve through the social work system or the public system has an impact on them having to care for depressed patients in their office.

Objective: to identify psychopharmacological prescription patterns in users over 18 years of age at the “Dr. AlejandroKorn” hospital from La Plata, Argentina. Methodology: observational, descriptive, cross-sectional study. Psychotropic drug prescriptions of inpatients and outpatients were surveyed.

Results: Of 425 users (71 % male), 218 were outpatients in community mental health centers or wards; 207 hospitalized in long-stay (n=86), medium-stay (n=34) and short-stay wards (n=87), with a median (range) of hospitalization of 9.5 (1-53.3) years. The most prevalent diagnoses were schizophrenia and other psychoses (71.1 %) and mental retardation (16.7 %). Up to 94.6 % received antipsychotics (AP), with 43.1 % first generation (FGA) and 77.2 % second generation; 74.6 % sedatives/hypnotics, mainly benzodiazepines; 42.6 % anticonvulsants and 13.4 % antidepressants. Antipsychotic polypharmacy (≥2 AP) was 42.3 %, reaching 69.9 % in FGA users. The AP dose was ≥600 mg chlorpromazine equivalents (eqCPZ) in 62.9 % and ≥1200 mg eqCPZ in 25.9 %. Up to 22.4 % of AP users received biperiden.

Conclusions: There is a high frequency of AP polypharmacy, high doses of AP and use of FGA. Also, high frequency of benzodiazepines prescription. It is necessary to prioritize dose reduction and deprescription of the different pharmacological groups.

This document constitutes the second section of the First Argentine Consensus on the management of Attention Deficit Hyperactivity Disorder (ADHD) in adulthood. The focus of this section is the synthesis of updated evidence on comprehensive therapeutic approaches to the condition in adult patients. The methodology described in the first part of the Consensus was followed, with the panel of experts carrying out an exhaustive review of the literature. This was followed by a subsequent debate on the available information, which resulted in the generation of this second section of the document, covering clinical and diagnostic aspects. During the debate and discussion stage of the formulation of these guidelines, it was decided to incorporate some points that are believed to be of great utility for the interdisciplinary team responsible for the management of ADHD patients in adulthood. In this sense, the second part of this document will address the clinical aspects of ADHD in adulthood, diagnostic assessment, neuropsychological profile, comorbidities and differential diagnoses.

Incluye: Higiene mental en la Argentina (1928), por Fernando Gorriti. Publicado en: La Semana Médica, No 35, págs. 1375 a 1382.

Objective: This study aimed to develop the first psychometric instrument for assessing mental illness malingering inthe workplace.

Method: Pearson's bivariate correlations were calculated between the dimensions of the PES-L and the SIMS and SCL-90-R tests. Sensitivity, specificity, and potential cutoff scores were determined using independent samples t-test and Cohen's d to determine effect size. ROC curve analysis was conducted to differentiate between two groups based on the total scale score.

Results: Results revealed an area under the curve of 0.81 (p = 0.000, 95 % CI: 0.73 - 0.89). A cutoff score of 14 correctly classified 72.16 % of potential simulator individuals.

Conclusion: The PES-L has shown potential as a psychometric instrument for detecting malingering in cases of mental health-related work absences.

Introduction: This study addresses the pervasive issue of academic stress among medical students at the University of Buenos Aires (UBA), shedding light on a critical aspect of student well-being

Materials and methods: Employing a prospective, cross-sectional methodology, a diverse cohort of 617 medical students participates, representing various courses. The research aimed to determine the prevalence of academic stress and investigate potential sociodemographic influences.

Results: Results revealed an alarming prevalence of academic stress, with 98.4 % of participants experiencing varying degrees. Specifically, 7.2 % exhibited mild stress, 73.1 % reporters moderate stress, and 19.6 % indicated profound levels of stress. The study identified significant associations between academic stress and sociodemographic factors, highlighting the influence of gender and place of origin. Notably, female students exhibited a high susceptibility to both moderate and profound academic stress, with odd ratio of 5.97 and 8.34, respectively. Additionally, foreign students, particularly those from non-Spanish-speaking countries, demonstrated a notably heightened risk of experiencing profound stress (OR=13).

Conclusion: This research underscores the critical need for targeting interventions and support mechanisms to address the persuasive issue of academic stress in medical education. Implementing strategies tailored to specific demographic groups, particularly female and foreign students, is paramount in fostering a conducive learning environment.