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The psychosocial impact concept improves the understanding of the effects of disasters on people and communities. However, its definition is not clear. This work explores consistencies between studies (k = 21) that refer to the psychosocial impact of disasters by way of a meta-analytic synthesis. This synthesis indicates that people are more prone to illness when they are exposed to a disaster, and less when they are protected (OR = 2.737). Please check the change conveys the intended meaning or amend Nevertheless, there are no differences in healthy responses, regardless of how protected or exposed they are (OR = 1.053). Finally, a model is proposed to explain four types of psychosocial impact: resilient, traumatic, sensitive, witness.
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Desastres , Necessidades e Demandas de Serviços de Saúde , Transtornos Mentais/epidemiologia , HumanosRESUMO
Childhood trauma is associated with different psychiatric disorders during adulthood. These disorders are often presented in comorbidity with depression. OBJECTIVE: To establish the relationship between psychiatric comorbidities and childhood traumatic events in patients with depression in Chile. METHODS: Three hundred and ninety-four patients with major depression were assessed using the MINI International Neuropsychiatric Interview and a screening for childhood trauma. RESULTS: Social anxiety disorder was associated with having witnessed domestic violence during childhood (OR = 2.2, CI 1.2 - 3.8), childhood physical abuse (OR = 2.7, CI 1.6 - 4.4), physical injury associated with physical abuse (OR = 2.3, CI 1.3 - 4.7) and sexual abuse by a non-relative (OR = 2.7, CI 1.3 - 4.2). Posttraumatic stress disorder was associated with physical injury associated with physical abuse (OR = 1.9, CI 1.1 - 3.6), sexual abuse by a relative (OR = 3.2, IC 1.8 - 5.9) and sexual abuse by a non-relative (OR = 2.2, CI 1.2 - 4.1). Antisocial personality disorder was associated with traumatic separation from a caregiver (OR = 3.2, CI 1.2 - 8.5), alcohol abuse by a family member (OR = 3.1, CI 1.1 - 8.1), physical abuse (OR = 2.8, CI 1.1 - 6.9) and sexual abuse by a non-relative (OR = 4.8, CI 1.2 - 11.5). Panic disorder was associated with sexual abuse by a relative (OR = 1.9, CI 1.1 - 3.1). Generalized anxiety disorder was associated with sexual abuse by a non-relative (OR = 1.9, CI 1.1- 3.3). CONCLUSIONS: Further clinical recognition is required in patients seeking help for depression in primary care. This recognition must take into account the patient's current psychiatric comorbidities and adverse childhood experiences.
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Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Atenção Primária à Saúde , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Transtorno da Personalidade Antissocial/epidemiologia , Transtorno da Personalidade Antissocial/psicologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Chile/epidemiologia , Comorbidade , Violência Doméstica/psicologia , Feminino , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Transtorno de Pânico/epidemiologia , Transtorno de Pânico/psicologia , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
BACKGROUND: Traumatic experiences during childhood may influence the development of mental disorders during adulthood. AIM: To determine clinical and psychosocial variables that are associated with a higher frequency of adverse childhood experiences (ACE) in patients who consult for depression in Primary Health Care clinics in Chile. MATERIAL AND METHODS: A socio-demographic interview, the mini international neuropsychiatric interview (MINI), a screening for ACE, a questionnaire for partner violence (PV), the Life Experiences Survey (LES) and the Hamilton Rating Scale for Depression (HRDS) were applied to 394 patients with major depression (87% women). RESULTS: Eighty two percent of patients had experienced at least one ACE and 43% of them reported three or more. Positive correlations were observed between the number of ACE and severity of depressive symptoms (r = 0.19; p < 0.01), psychiatric comorbidities (r = 0.23; p < 0.01), partner violence events (r = 0.31; p < 0.01), vital stressful events (r = 0.12; p < 0.01), number of depressive episodes (r = 0.16; p < 0.01), duration of the longer depressive episode (r = 0.12; p < 0.05) and suicidal tendency according to HDRS (r = 0.16; p < 0.01). An inverse correlation was observed between frequency of ACE and age at the first depressive episode (r = -0.12; p < 0.05). CONCLUSIONS: These data are consistent with the hypothesis that early trauma is associated with more severe and complex depressive episodes during adulthood.
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Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Transtorno Depressivo/etiologia , Transtorno Depressivo/psicologia , Acontecimentos que Mudam a Vida , Atenção Primária à Saúde/estatística & dados numéricos , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Criança , Chile , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Distribuição por Sexo , Fatores Socioeconômicos , Ideação Suicida , Inquéritos e QuestionáriosRESUMO
In 2018, Complex Post Traumatic Stress Disorder (CPTSD) was officially recognized as a distinct syndrome in the International Classification of Diseases, 11th Revision (ICD-11). This recognition aimed to differentiate between neurotic disorders secondary to stressful situations and somatoform disorders, and disorders specifically associated with stress. The inclusion of CPTSD in the ICD-11 marked the culmination of two decades of research focused on understanding its symptoms, treatments, and risk factors. However, despite the progress made, a comprehensive meta-analysis to elucidate the specific risk factors and impact on the development of CPTSD is still lacking. The objective of this article is to conduct such a meta-analysis. A total of 24 studies were selected for analysis, and the findings revealed several key risk factors associated with the development of CPTSD. The main risk factor identified is having experienced sexual abuse in childhood (k = 12; OR = 2.880). In addition, childhood physical abuse (k = 11; OR = 2.841), experiencing emotional neglect during childhood (k = 5; OR = 2.510), physical abuse throughout life (k = 8; OR = 2.149) and being a woman (k = 13; OR = 1.726) were also significant risk factors.
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Delitos Sexuais , Transtornos de Estresse Pós-Traumáticos , Feminino , Humanos , Classificação Internacional de Doenças , Fatores de Risco , Delitos Sexuais/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , MasculinoRESUMO
BACKGROUND: Sleep problems have a high recurrence in children and adolescents with attention deficit disorder with hyperactivity (ADHD) experience high rates of sleep problems. OBJECTIVE: Understand the relationship between sleep disorders and ADHD symptoms. METHODS AND PROCEDURES: A systematic review was performed using electronic databases, including PubMed, Cochrane Library, Scopus, Lilacs, and Psychology Database (ProQuest) systems. The quality of each article was assessed using a 5-criteria checklist, measuring relevant dimensions. OUTCOMES AND RESULTS: The review analyzed fifteen articles, were included that raised the realizations among sleep problems in the population of children with ADHD, obtaining a total of 1645 children and adolescents with ADHD that were compared with typical development groups. The articles selected for this systematic review of observational design have a high quality. CONCLUSIONS AND IMPLICATIONS: Children and adolescents with ADHD have sleep problems, which may exacerbate or be the cause of the ADHD clinic, affecting the quality of life of children and their families. Early inquiry and a timely approach can contribute to reducing the severity of ADHD symptoms.
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Transtorno do Deficit de Atenção com Hiperatividade , Transtornos do Sono-Vigília , Humanos , Criança , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Qualidade de Vida , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/psicologiaRESUMO
Background: Borderline personality disorder (BPD) is characterized by symptoms associated with difficulties in emotion regulation, altered self-image, impulsivity, and instability in personal relationships. A relationship has been found between BPD symptoms and altered neuropsychological processes. Studies of event-related potentials (ERP) measured with electroencephalogram (EEG) have found neural correlates related to BPD symptoms. Of note is the P300 component, considered a potential mental health biomarker for trauma-associated disorders. However, no meta-analysis has been found to demonstrate this relationship.Objectives: To evaluate the relationship between the P300 component and BPD symptoms. To evaluate the relationship of other ERP components with BPD symptoms.Methods: The method and procedure were adjusted to the PRISMA checklist. The search was performed in three databases: WOS, Scopus and PubMed. A Random Effects Model was used to perform the analysis of the studies. In addition, a meta-regression was performed with % women, Gini and GDP. Finally, a descriptive analysis of the main results found between P300, other ERP components (LPP, P100 and ERN/Ne) and BPD symptoms was performed.Results: From a review of 485 articles, a meta-analysis was performed with six articles that met the inclusion criteria. A moderate, positive relationship was found between the P300 component and BPD symptoms (REM = .489; p < .001). It was not possible to perform meta-analyses for other ERP components (LPP, P100 and ERN/Ne) due to the low number of articles found.Conclusion: The idea that P300 could be considered for use as a biomarker to identify altered neural correlates in BPD is reinforced. In addition, a moderating effect of inequality (Gini) was detected.
The P300 component of event-related potentials could be considered for use as a possible biomarker to identify altered neural correlates in Borderline Personality Disorder.There is support for the proposition that an altered P300 would be present in disorders related to exposure to traumatic events.P300 could be used to evaluate the therapeutic processes associated with the clinical symptoms of Borderline Personality Disorder.
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Transtorno da Personalidade Borderline , Humanos , Feminino , Masculino , Transtorno da Personalidade Borderline/diagnóstico , Potenciais Evocados/fisiologia , Eletroencefalografia , Comportamento Impulsivo , BiomarcadoresRESUMO
Solastalgia is a recent concept that refers to disruptive psychological responses in people exposed to environmental degradation. The aim of this study was to determine the number of dimensions solastalgia has using a sample of people exposed to the effects of climate change in the coastal dry land of Maule region, Chile. In order to achieve this, a Scale Of Solastalgia (SOS) was designed and then validated, by means of applying it to 223 inhabitants at the municipalities of Pencahue (n = 105) and Curepto (n = 118), who were also evaluated by the Short Post-traumatic Stress Disorder Rating Interview (SPRINT-E). Using robust validation methods (Parallel factor analysis and Omega), two dimensions were obtained for solastalgia: solace and algia. Both correlate with the SPRINT-E scale (r = 0.150, p < 0.01 and r = 0.359, p < 0.01, respectively) and have 58% sensitivity and 67% specificity to detect cases of post-traumatic stress disorder (PTSD). Like PTSD, solastalgia is related to psychopathologies expected after disasters and also presents a spatial pattern where the concentration of positive cases occurs in places of greater exposure to environmental change or degradation.
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Desastres , Incêndios , Transtornos de Estresse Pós-Traumáticos , Incêndios Florestais , Humanos , Secas , Transtornos de Estresse Pós-Traumáticos/psicologia , Mudança ClimáticaRESUMO
OBJECTIVE: Since its first definition, the number of dimensions of the posttraumatic stress disorder (PTSD) has increased (e.g., 1 to 7). This could be caused by 2 methodological reasons. First, the studies do not select representative samples of the population and do not consider the magnitude of exposure to the same event. Second, they use nonrobust data analysis, which increases the number of dimensions artificially. The aim is to determine how many dimensions PTSD has, when both sources of error are controlled. METHOD: From 25,400 representative participants of the same population exposed to an earthquake and evaluated with the Davidson Trauma Scale, 127 smaller samples of 200 participants were obtained and classified according to the Mercalli magnitude. Parallel factor analyses (PFA), exploratory structural equations models (ESEM), and classic exploratory factor analysis (EFA) were applied to each sample. RESULTS: There were significant differences in fit and number of dimensions between the high and low Mercalli magnitude. In high exposure conditions: There were 1 dimension according to PFA and 3 according to EFA; ESEM and CFA indicated good fit. The main finding was that PTSD has a unique dimension that includes all of its symptoms. CONCLUSIONS: The need to use robust methods of analysis to evaluate data from samples homogeneously exposed to the same potentially traumatic event is argued. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Progressive changes in local environmental scenarios, accelerated by global climate change, can negatively affect the mental health of people who inhabit these areas. The magnitude of these effects may vary depending on the socioeconomic conditions of people and the characteristics of the environment, so certain territories can be more vulnerable than others. In this context, the present study aimed to geographically analyse the levels of psychosocial impact and the types of disruptive responses related to the new territorial scenarios caused by climate change in the coastal drylands of the Maule region, Chile. For this purpose, 223 people from two communes (Curepto and Pencahue) were psychosocially evaluated for post-traumatic stress disorder (PTSD) together with a survey of the prevailing sociodemographic and socioeconomic conditions in relation to the environmental variables of the territory. All information was georeferenced, stored within an ArcGIS Desktop geographic information system (GIS) and then investigated by application of contingency tables, ANOVA and local clustering analysis using SSP statistical software. The results indicated a high level of PTSD in the population, with significant differences related to age and education as well as employment conditions and income. The spatial results showed high PTSD values in the communal capital of Curepto in the central agricultural valley near the estuary of the local river, while the existence of coldspots was observed in the central valley of the Pencahue commune. It was concluded that proximity to population centres and surface water sources played the greatest role for the development of PTSD.
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Mudança Climática , Transtornos de Estresse Pós-Traumáticos , Chile/epidemiologia , Sistemas de Informação Geográfica , Humanos , Saúde Mental , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
OBJECTIVES: The problem is to determine whether, after a disaster, unemployment is a possible cause of post-traumatic stress disorder (PTSD) - the classic model, or whether PTSD is a possible cause of unemployment - the alternative model. MATERIAL AND METHODS: The study was conducted on a probabilistic sample of 26 213 adults who provided responses using the Davidson Trauma Scale and lived in regions near or far from the epicenter (Cobquecura, the coast of Chile) of the earthquake and tsunami of February 27, 2010. RESULTS: Independent of the proximity to the epicenter, there is an association between PTSD, unemployment, female sex and the poverty line. For regions close to the epicenter, the alternative model has better adjustment indicators than the classic model. CONCLUSIONS: Given the adjustment of the alternative model, the occurrence of PTSD cases is more likely to explain the unemployment condition. Int J Occup Med Environ Health. 2021;34(6):755-66.
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Desastres , Transtornos de Estresse Pós-Traumáticos , Chile , Feminino , Humanos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , DesempregoRESUMO
OBJECTIVE: To establish differentiated depressive subtypes using a latent class analysis (LCA), including clinical and functional indicators in a sample of depressed patients consulted in Chilean Primary Health Care. METHODS: A LCA was performed on a sample of 297 depressed patients consulted in Chilean PHC. The Mini International Neuropsychiatric Interview, the Hamilton Depression Rating Scale, the Outcome Questionnaire -social role, and interpersonal subscales were as instruments. A regression analysis of the different subtypes with sociodemographic and adverse life experiences was performed. RESULTS: In a sample characterized by 87.5% of women, two, three, and four latent class models were obtained. The three-class model likely represents the best clinical implications. In this model, the classes were labeled: "complex depression" (CD) (58% of the sample), "recurrent depression" (RD) (34%), and "single depression episode" (SD) (8%). Members of CD showed a higher probability of history of suicide attempts, interpersonal, and social dysfunction. Psychiatric comorbidities differentiated the RD from SD. According to a multinomial regression model, childhood trauma experiences, recent stressful life experiences, and intimate partner violence events were associated with the CD class (p < 0.01). Limitations. The vast majority of participants were females from Chile and the sample studied was not random. So, the results may not necessarily represent outpatient clinics. CONCLUSIONS: This study can provide additional evidence that depression, specifically in female gender, could be better understood as a complex heterogeneous disorder when clinical and functional indicators are studied. Furthermore, adverse life experiences starting in childhood could lead to a differentiated complex depressive subtype.
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Recent findings indicate that both disruptive Post-Traumatic Stress Disorder (PTSD) and healthy Post-Traumatic Growth (PTG) responses have some spatial distribution depending on where they are measured and the different degrees of exposure that people may have to a critical event (e.g., earthquake). Less is known about how these responses change as a function of space and time after these events. The objective of this study was to enter deeper into this relationship analysing how PTSD and PTG responses vary in their spatial distribution 6 and 7 years after an earthquake (such as the one that occurred on 27 February, 2010 in Cauquenes City, Chile). Spatial analyses based on Geographic Information Systems (GIS) were performed to detect global and local geographic clustering. Investigating 171 (2016) and 106 (2017) randomly selected adults from Cauquenes, we demonstrated that 7 years after the event only 4 variables were spatially clustered, i.e. personal mental strength, interpersonal relations, new possibilities and appreciation of life), all of them PTG dimensions; This result contrasted with the situation the previous year (2016), when 7 variables were clustered (total PTG, spiritual change, new possibilities, appreciation of life, PTSD symptoms, PTSD reactions and PTSD in total). The spatial identifications found could facilitate the comparison of mental health conditions in populations and the impact of recovery programmes in communities exposed to disasters.
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Terremotos , Saúde Mental/estatística & dados numéricos , Crescimento Psicológico Pós-Traumático , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adaptação Psicológica , Adulto , Chile/epidemiologia , Análise por Conglomerados , Demografia , Feminino , Sistemas de Informação Geográfica , Humanos , Relações Interpessoais , Masculino , Análise Espacial , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
The occurrence of earthquakes can cause psychiatric problems expressed as unpleasant and uncontrollable memories of the event termed post-traumatic stress disorder (PTSD). Mapping the location of people and identifying their exposure and reactions to an earthquake can be extremely valuable from a public, mental health point of view. The main objective of this study was to examine people with respect to PTSD and healthy post-traumatic growth (PTG) after an earthquake searching for expression of geographic clustering that could be useful for a better understanding of mental health conditions. Geographic information systems analyses were performed to detect global and local geographic clustering. Investigating 171 randomly selected adults from Cauquenes, Chile, we demonstrated spatially clustered variables related to PTSD and PTG in Cauquenes six years after an earthquake. Urban and peri-urban areas had clear differences (hotspots/coldspots). The spatial identifications found should facilitate exploring the impact of mental health programmes in communities exposed to disasters like earthquakes, thereby improving their quality of life as well as reducing overall costs.
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Terremotos , Mapeamento Geográfico , Saúde Mental/estatística & dados numéricos , Desastres Naturais , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adaptação Psicológica , Idoso , Chile , Feminino , Sistemas de Informação Geográfica , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Características de Residência , Resiliência Psicológica , Índice de Gravidade de Doença , EspiritualidadeRESUMO
OBJECTIVE: This is the first time that the effectiveness of cognitive-behavioural therapy for post-disaster stress (CBT-PD) in symptoms of posttraumatic stress disorder (PTSD) has been tested outside the United States of America. DESIGN: Quasi-experiment with three groups. In the quasi-control group, complete CBT-PD was applied even though its members did not have PTSD; in quasi-experimental conditions, participants received complete treatment because they had this diagnosis; and in the third group, participants with PTSD received an abbreviated treatment (double sessions) due to organisational requirements. LOCATION: Primary health care workers in Constitución (Chile), city exposed to earthquake and tsunami; public department workers in Talca (city exposed only to earthquake) and teachers from a school (Constitución). PARTICIPANTS: A total of 13 of the 91 people diagnosed with PTSD participated. In addition, 16 people without diagnosis voluntarily participated. The treatment was completed by 29 participants. There were no dropouts. Only 1 of the 9 participants in the quasi-experimental group did not respond to treatment. INTERVENTIONS: CBT-PD is a group therapy (10-12 sessions) that includes psychoeducation, breathing retraining, behavioural activation and cognitive restructuring. CBT-PD (complete and abbreviated) was applied between September and December 2010. MEASUREMENTS: Short Posttraumatic Stress Disorder Rating Interview (SPRINT-E) was used to measure PTSD symptoms before and after treatment. RESULTS: The group that received the complete treatment and was diagnosed with PTSD showed a significant decrease in the total symptoms to below dangerous levels (IGAAB: 31.556; p<0.01; 95%CI: 0.21-2.01]; η2=0.709). DISCUSSION: The effectiveness and benefits of incorporating CBT-PD in the health network after events like disasters were discussed.
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Terapia Cognitivo-Comportamental , Terremotos , Transtornos de Estresse Pós-Traumáticos/terapia , Tsunamis , Chile , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
OBJECTIVE: To identify the clinical and psychosocial factors associated with psychiatric comorbidity in patients consulting for depression in Primary Health Care (PHC) in Chile. METHODS: 394 patients with a diagnosis of major depression being treated in a Chilean PHC were evaluated using a sociodemographic and clinical interview, the mini-international neuropsychiatric interview (MINI), a childhood trauma events (CTEs) screening, the intimate partner violence (IPV) scale, the Life Experiences Survey (LES), and the Hamilton Depression Rating Scale (HDRS). RESULTS: Positive correlations were established between higher number of psychiatric comorbidities and severity of depressive symptoms (r = 0.358), frequency of CTEs (r = 0.228), frequency of IPV events (r = 0.218), frequency of recent stressful life events (r = 0.188), number of previous depressive episodes (r = 0.340), and duration of these (r = 0.120). Inverse correlations were determined with age at the time of the first consultation (r = -0.168), age of onset of depression (r = -0.320), and number of medical comorbidities (r = -0.140). Of all associated factors, early age of the first depressive episode, CTEs antecedents, and recent stressful life events explain 13.6% of total variability in psychiatric comorbidities. CONCLUSIONS: A higher prevalence of psychiatric comorbidity among subjects seeking help for depression in Chilean PHCs is associated with early onset of depression, clinical severity, chronicity, and interpersonal adversity experienced since childhood.
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OBJECTIVE: After the earthquake and tsunami in Chile (F-27), we studied the effect of socio-demographic factors, exposure to the event, and state aid received on comorbidity from panic disorder (PD) and posttraumatic stress disorder (PTSD). METHOD: Surveys that include the administration of the Davidson Trauma Scale (DTS) to 246 inhabitants. RESULTS: 19.1 % comorbidity was found (r=.583, R(2)=.340, p<.01). Females homeowners have a higher risk of PD and PTSD. State aid is associated with more cases of PD. CONCLUSIONS: We designed risk/resistance profiles against earthquakes/tsunamis and an instrument to detect cases at risk of PTSD. We suggest guidelines so that the government can improve its role after disasters.
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Desastres , Terremotos , Transtorno de Pânico/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Sobreviventes/psicologia , Adolescente , Adulto , Idoso , Chile/epidemiologia , Feminino , Habitação , Humanos , Masculino , Pessoa de Meia-Idade , Ocupações , Transtorno de Pânico/etiologia , Religião , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Transtornos de Estresse Pós-Traumáticos/etiologia , Estudantes/psicologia , Tsunamis , Adulto JovemRESUMO
OBJECTIVE: After the earthquake and tsunami in Chile (F-27), we studied the effect of socio-demographic factors, exposure to the event, and state aid received on comorbidity from panic disorder (PD) and posttraumatic stress disorder (PTSD). METHOD: Surveys that include the administration of the Davidson Trauma Scale (DTS) to 246 inhabitants. RESULTS: 19.1 % comorbidity was found (r=.583, R2=.340, p<.01). Females homeowners have a higher risk of PD and PTSD. State aid is associated with more cases of PD. CONCLUSIONS: We designed risk/resistance profilesagainst earthquakes/tsunamis and an instrument to detect cases at risk of PTSD. We suggest guidelines so that the government can improve its role after disasters.
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Desastres , Terremotos , Transtorno de Pânico/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Idoso , Chile/epidemiologia , Comorbidade , Planejamento em Desastres , Feminino , Guias como Assunto , Habitação , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno de Pânico/etiologia , Prevalência , Religião , Fatores de Risco , Classe Social , Transtornos de Estresse Pós-Traumáticos/etiologia , Índices de Gravidade do Trauma , Tsunamis , Adulto JovemRESUMO
BACKGROUND: On February 27, 2010 (F-27), an earthquake and tsunami occurred having a significant impact on the mental health of the Chilean population, leading to an increase in cases of post-traumatic stress disorder (PTSD). OBJECTIVES: Within this context, validated for the first time in Chile was the Davidson Trauma Scale (DTS) using three samples (each one consisting of 200 participants), two of them random from the Chilean population. RESULTS: Reliability analyses (i.e., α=0.933), concurrent validity (63% of the items are significantly correlated with the criteria variable "degree of damage to home") and construct validity (i.e., CMIN = 3.754, RMSEA = 0.118, NFI = 0.808, CFI = 0.850 and PNFI = 0.689) indicate validity between regular and good for DTS. However, a new short version of the scale (DTS-SF) created using the items with heavier factor weights, presented better fits (CMIN = 2.170, RMSEA = 0.077, NFI = 0.935, CFI = 0.963, PNFI = 0.697). DISCUSSION: Finally, the usefulness of DTS and DTS-SF is discussed, the latter being briefer, valid and having better psychometric characteristics.
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Background: Traumatic experiences during childhood may influence the development of mental disorders during adulthood. Aim: To determine clinical and psychosocial variables that are associated with a higher frequency of adverse childhood experiences (ACE) in patients who consult for depression in Primary Health Care clinics in Chile. Material and Methods: A socio-demographic interview, the mini international neuropsychiatric interview (MINI), a screening for ACE, a questionnaire for partner violence (PV), the Life Experiences Survey (LES) and the Hamilton Rating Scale for Depression (HRDS) were applied to 394 patients with major depression (87% women). Results: Eighty two percent of patients had experienced at least one ACE and 43% of them reported three or more. Positive correlations were observed between the number of ACE and severity of depressive symptoms (r = 0.19; p < 0.01), psychiatric comorbidities (r = 0.23; p < 0.01), partner violence events (r = 0.31; p < 0.01), vital stressful events (r = 0.12; p < 0.01), number of depressive episodes (r = 0.16; p < 0.01), duration of the longer depressive episode (r = 0.12; p < 0.05) and suicidal tendency according to HDRS (r = 0.16; p < 0.01). An inverse correlation was observed between frequency of ACE and age at the first depressive episode (r = -0.12; p < 0.05). Conclusions: These data are consistent with the hypothesis that early trauma is associated with more severe and complex depressive episodes during adulthood.
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Humanos , Masculino , Feminino , Criança , Adulto , Pessoa de Meia-Idade , Atenção Primária à Saúde/estatística & dados numéricos , Transtorno Depressivo/etiologia , Transtorno Depressivo/psicologia , Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Acontecimentos que Mudam a Vida , Escalas de Graduação Psiquiátrica , Fatores Socioeconômicos , Índice de Gravidade de Doença , Chile , Estudos Transversais , Inquéritos e Questionários , Distribuição por Sexo , Ideação Suicida , Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricosRESUMO
Objetivo Después del terremoto y tsunami de Chile (27-F), estudiamosel efecto de factores socio-demográficos, de exposición al evento y de ayuda estatal recibida en la comorbilidad entre trastorno de pánico (CAP) y estrés postraumático (TEPT). Método Encuestas que incluían la Escala de Trauma de Davidson(DTS)a 246 habitantes. Resultados Se encontró19,1% de comorbilidad (r=,583; R2=,340; p<,01). Quienes tienen mayor riesgo de sufrir CAP y TEPT son las mujeresdueñas de casa. La ayuda estatal se asocia amás casos de CAP. Conclusiones Diseñamos perfiles de riesgo/resistencia anteterremotos/tsunamis y uninstrumento (EP-TEPT) para detectar casos en riesgo de TEPT. Sugerimos pautas para que el Estado mejore su rol después de desastres.(AU)
Objective After the earthquake and tsunami in Chile (F-27), we studied the effect of socio-demographic factors, exposure to the event, and state aid received on comorbidity from panic disorder (PD) and posttraumatic stress disorder (PTSD). Method Surveys that include the administration of the Davidson Trauma Scale (DTS) to 246 inhabitants. Results 19.1 % comorbidity was found (r=.583, R2=.340, p<.01). Females homeowners have a higher risk of PD and PTSD. State aid is associated with more cases of PD. Conclusions We designed risk/resistance profilesagainst earthquakes/tsunamis and an instrument to detect cases at risk of PTSD. We suggest guidelines so that the government can improve its role after disasters.(AU)