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Objective: Describe barriers and challenges in the implementation of the global Mental Health Gap Action Program (mhGAP), and determine the association between facilitators of implementation, accessibility, acceptability, and supervision, in Chocó, Colombia. Methods: Cross-sectional evaluation study, with mixed and sequential methods. Forty-one people participated: 30 health personnel and 11 administrative workers. Five focus groups were formed within the framework of the mhGAP training. The Likert scale of implementation drivers was used to determine factors affecting the strategy, such as system facilitators, accessibility of the strategy, adaptation and acceptability, and training and supervision. Semi-structured interviews were also conducted, with a subsequent thematic analysis. Results: A statistically significant correlation was found between the components of implementation. This was reaffirmed by the information from the interviews. Notable barriers include dispersion, armed conflict, difficulty in changing one's perspective on the area where they live, and administrative problems in accessing treatment. These factors are addressed in a proposed care pathway. Conclusions: With respect to mhGAP in the department of Chocó, despite adequate acceptability, access, and supervision, there are barriers and challenges at the social, geographical, political, cultural, and health administration levels, which could be overcome through implementation of locally-built intersectoral recovery routes.
Objetivo: Descrever barreiras e desafios na implementação do Programa de Ação para Reduzir as Lacunas em Saúde Mental (mhGAP, na sigla em inglês) e determinar a associação entre facilitadores de implementação, acessibilidade, aceitabilidade e supervisão em Chocó, Colômbia. Métodos: Estudo avaliativo de corte transversal, com métodos mistos e sequenciais, que contou com 41 participantes (30 da equipe de saúde e 11 da equipe administrativa). Um total de cinco grupos focais foram formados como parte do treinamento do mhGAP. Utilizou-se a escala de motivadores de implementação, que determinou fatores como facilitadores do sistema para implementação, acessibilidade da estratégia, adaptação e aceitabilidade, treinamento e supervisão da estratégia. Também foram realizadas entrevistas semiestruturadas, com posterior análise temática. Resultados: Foi encontrada uma correlação estatisticamente significativa entre os componentes da implementação, o que foi reafirmado com as informações das entrevistas. Em termos das barreiras identificadas, destacam-se fatores como dispersão, conflito armado, a dificuldade de mudar a perspectiva da pessoa sobre a área em que vive e problemas administrativos no acesso ao tratamento. Esses fatores são abordados em uma proposta de via de atendimento. Conclusões: Apesar da aceitabilidade, do acesso e da supervisão adequados, há barreiras e desafios sociais, geográficos, políticos, culturais e de administração de saúde no mhGAP do departamento de Chocó que poderiam ser superados com a implementação de rotas de recuperação intersetoriais, construídas a partir do próprio território.
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RESUMEN Objetivo. Describir barreras y desafíos en la implementación del Programa de Acción Mundial para Reducir las Brechas de Atención en Salud Mental mhGAP, y determinar la asociación entre facilitadores de implementación, accesibilidad, aceptabilidad y supervisión, en Chocó, Colombia. Métodos. Estudio evaluativo de corte transversal, con métodos mixtos y secuenciales. Se contó con la participación de 41 personas (30 correspondientes a personal de salud y 11 personas del área administrativa). Se conformaron cinco grupos focales, en el marco de la formación en mhGAP. Se usó la escala de impulsores de implementación, que determinó factores como: facilitadores del sistema para la implementación, accesibilidad de la estrategia, adaptación y aceptabilidad, formación y supervisión en la estrategia. También se realizaron entrevistas semiestructuradas, con un posterior análisis temático. Resultados. Se encontró una correlación estadísticamente significativa entre los componentes de la implementación, lo cual fue reafirmado con la información de las entrevistas. A nivel de las barreras señaladas, se destacan factores como dispersión, conflicto armado, la dificultad para cambiar la perspectiva de la zona en la que se vive y los problemas administrativos para acceder a los tratamientos. Estos factores se abordan en una propuesta de ruta de atención. Conclusiones. En mhGAP en el departamento del Chocó, pese a una adecuada aceptabilidad, acceso y supervisión, se evidencian barreras y desafíos de orden social, geográfico, político, cultural y a nivel de la administración en salud, que podrían ser superados con la implementación de rutas intersectoriales de recuperación, construidas desde el mismo territorio.
ABSTRACT Objective. Describe barriers and challenges in the implementation of the global Mental Health Gap Action Program (mhGAP), and determine the association between facilitators of implementation, accessibility, acceptability, and supervision, in Chocó, Colombia. Methods. Cross-sectional evaluation study, with mixed and sequential methods. Forty-one people participated: 30 health personnel and 11 administrative workers. Five focus groups were formed within the framework of the mhGAP training. The Likert scale of implementation drivers was used to determine factors affecting the strategy, such as system facilitators, accessibility of the strategy, adaptation and acceptability, and training and supervision. Semi-structured interviews were also conducted, with a subsequent thematic analysis. Results. A statistically significant correlation was found between the components of implementation. This was reaffirmed by the information from the interviews. Notable barriers include dispersion, armed conflict, difficulty in changing one's perspective on the area where they live, and administrative problems in accessing treatment. These factors are addressed in a proposed care pathway. Conclusions. With respect to mhGAP in the department of Chocó, despite adequate acceptability, access, and supervision, there are barriers and challenges at the social, geographical, political, cultural, and health administration levels, which could be overcome through implementation of locally-built intersectoral recovery routes.
RESUMO Objetivo. Descrever barreiras e desafios na implementação do Programa de Ação para Reduzir as Lacunas em Saúde Mental (mhGAP, na sigla em inglês) e determinar a associação entre facilitadores de implementação, acessibilidade, aceitabilidade e supervisão em Chocó, Colômbia. Métodos. Estudo avaliativo de corte transversal, com métodos mistos e sequenciais, que contou com 41 participantes (30 da equipe de saúde e 11 da equipe administrativa). Um total de cinco grupos focais foram formados como parte do treinamento do mhGAP. Utilizou-se a escala de motivadores de implementação, que determinou fatores como facilitadores do sistema para implementação, acessibilidade da estratégia, adaptação e aceitabilidade, treinamento e supervisão da estratégia. Também foram realizadas entrevistas semiestruturadas, com posterior análise temática. Resultados. Foi encontrada uma correlação estatisticamente significativa entre os componentes da implementação, o que foi reafirmado com as informações das entrevistas. Em termos das barreiras identificadas, destacam-se fatores como dispersão, conflito armado, a dificuldade de mudar a perspectiva da pessoa sobre a área em que vive e problemas administrativos no acesso ao tratamento. Esses fatores são abordados em uma proposta de via de atendimento Conclusões. Apesar da aceitabilidade, do acesso e da supervisão adequados, há barreiras e desafios sociais, geográficos, políticos, culturais e de administração de saúde no mhGAP do departamento de Chocó que poderiam ser superados com a implementação de rotas de recuperação intersetoriais, construídas a partir do próprio território.
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INTRODUCTION: The COVID-19 pandemic is having an impact on multiple levels, one being the way of providing mental health care services. A study was proposed in order to identify the standpoints regarding the role we must assume as psychiatrists in the setting of this pandemic in Colombia. METHODS: A study was developed employing a Delphi-type methodology. Three types of psychiatrist were included for the application of the instrument: directors of academic psychiatry programmes, directors of mental health institutions and private practitioners. RESULTS: Responses were collected over the course of a month (between April and May) by 24 participants corresponding to 14 private practitioners (58.3%), 6 heads of academic programmes (25.1%) and 4 directors of mental health services (16.6%). The results, grouped around the psychiatric work, describe the impact generated by the pandemic and the possible role of the specialist. CONCLUSIONS: Consistency was identified around the need to provide a differential approach according to the vulnerabilities of each group of people exposed to the pandemic; as well as the remote provision of health care through technology, often using videoconferencing.
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INTRODUCTION: The COVID-19 pandemic is having an impact on multiple levels, one being the way of providing mental health care services. A study was proposed in order to identify the standpoints regarding the role we must assume as psychiatrists in the setting of this pandemic in Colombia. METHODS: A study was developed employing a Delphi-type methodology. Three types of psychiatrist were included for the application of the instrument: directors of academic psychiatry programmes, directors of mental health institutions and private practitioners. RESULTS: Responses were collected over the course of a month (between April and May) by 24 participants corresponding to 14 private practitioners (58.3%), 6 heads of academic programmes (25.1%) and 4 directors of mental health services (16.6%). The results, grouped around the psychiatric work, describe the impact generated by the pandemic and the possible role of the specialist. CONCLUSIONS: Consistency was identified around the need to provide a differential approach according to the vulnerabilities of each group of people exposed to the pandemic; as well as the remote provision of health care through technology, often using videoconferencing.
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COVID-19 , Transtornos Mentais/terapia , Papel do Médico , Psiquiatria , Atitude do Pessoal de Saúde , COVID-19/prevenção & controle , COVID-19/psicologia , Colômbia , Atenção à Saúde/métodos , Atenção à Saúde/organização & administração , Técnica Delphi , Feminino , Humanos , Masculino , Transtornos Mentais/etiologia , Serviços de Saúde Mental/organização & administração , Psiquiatria/métodos , Psiquiatria/organização & administração , Telemedicina/métodos , Telemedicina/organização & administração , Comunicação por VideoconferênciaRESUMO
RESUMEN Introducción: La pandemia de COVID-19 genera impactos en múltiples niveles, uno de ellos es la forma de prestar servicios de atención en salud mental. Este estudio se planteó con el fin de identificar las posturas sobre el rol que debemos asumir como psiquiatras en el marco de la pandemia de COVID-19 en Colombia. Métodos: Se desarrolló un estudio mediante metodología tipo Delphi. Para la aplicación del instrumento, se incluyeron 3 tipos de participantes: psiquiatras directores de programas académicos de psiquiatría, psiquiatras directores de instituciones de salud mental y psiquiatras que ejercieran su labor clínica fuera del contexto académico. Resultados: Recolectaron las respuestas en el transcurso de 1 mes (entre abril y mayo) 24 participantes: 14 psiquiatras clínicos (58,3%), 6 directores de residencia (25,1%) y 4 coordinadores de servicios de salud mental (16,6%). Se describen los resultados agrupados en torno al quehacer psiquiátrico, el impacto generado por la pandemia y el posible rol del especialista. Conclusiones: Se identificó consistencia en torno a la necesidad de brindar un abordaje diferencial acorde con las vulnerabilidades propias de cada grupo de personas expuestas a la pandemia, así como la implementación de estrategias de atención psiquiátrica a distancia. © 2021 Publicado por Elsevier España, S.L.U. en nombre de Asociación Colombiana de Psiquiatría.
ABSTRACT Introduction: The COVID-19 pandemic is having an impact on multiple levels, one being the way of providing mental health care services. A study was proposed in order to identify the standpoints regarding the role we must assume as psychiatrists in the setting of this pandemic in Colombia. Methods: A study was developed employing a Delphi-type methodology. Three types of psychiatrist were included for the application of the instrument: directors of academic psychiatry programmes, directors of mental health institutions and private practitioners. Results: Responses were collected over the course of a month (between April and May) by 24 participants corresponding to 14 private practitioners (58.3%), 6 heads of academic programmes (25.1%) and 4 directors of mental health services (16.6%). The results, grouped around the psychiatric work, describe the impact generated by the pandemic and the possible role of the specialist. Conclusions: Consistency was identified around the need to provide a differential approach according to the vulnerabilities of each group of people exposed to the pandemic; as well as the remote provision of health care through technology, often using videoconferencing.
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OBJECTIVE: To describe the experience of physicians and patients in the Telepsychiatry programme at the University of Antioquia's Faculty of Medicine in the first 12 months after its implementation in eight towns across Antioquia. METHODOLOGY: A descriptive study involving the evaluation of 111 patients during the programme's first year. An instrument was designed to evaluate patients' satisfaction and the Technology Acceptance Model (TAM) was used to evaluate the health professionals' satisfaction. RESULTS: 111 patients were seen on 340 occasions. 70 out of the 111 patients (63.1%) were seen by Telepsychiatry at least twice in the first year of implementation. A sample of 38 patients (34%) was used to evaluate their experience, of which 94.7% said their problem had been solved and 100% were highly satisfied. Nine health professionals took part in the programme, who agreed that the technology was useful and easy to use. They also stated that they wanted to continue using it. CONCLUSION: Health systems across the globe have failed to provide an adequate response to the mental health burden. Therefore, strategies such as telepsychiatry are considered an ideal treatment modality to give patients living in remote locations the specialised attention that they need.
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Atitude do Pessoal de Saúde , Transtornos Mentais/terapia , Satisfação do Paciente/estatística & dados numéricos , Psiquiatria/métodos , Telemedicina , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Colômbia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Telemedicina/métodos , Telemedicina/organização & administração , Resultado do Tratamento , Adulto JovemRESUMO
Objetivo: Describir la experiencia que han tenido los médicos y pacientes del programa de Telepsiquiatría de la Facultad de Medicina de la Universidad de Antioquia en los primeros 12 meses de su implementación en 8 municipios del departamento. Métodos: Estudio descriptivo, que incluyó a 111 pacientes atendidos durante el primer año. Se diseñó un instrumento para evaluar la satisfacción de los pacientes y se empleó el instrumento de aceptación de tecnología para evaluar la de los profesionales de la salud. Resultados: Se realizaron 340 atenciones durante ese periodo a 111 pacientes; 70 (63,1%) de ellos recibieron al menos 2 atenciones por telepsiquiatría en el primer año. Se evaluó la experiencia en una muestra de 38 pacientes (34%), quienes manifestaron la resolución del problema (94,7%) y una satisfacción alta (100%). En el programa participaron 9 profesionales de la salud, que estuvieron de acuerdo en que la tecnología es útil y fácil de usar y tienen la intención de seguir usándola. Conclusiones: Los sistemas de salud de todo el mundo no han dado una respuesta adecuada a la carga de trastornos mentales; por esto, estrategias como la telepsiquiatría se consideran una modalidad de atención ideal para personas que viven en lugares remotos y tienen dificultad de acceso a los servicios de salud especializados, con adecuada aceptación.
Objective: To describe the experience of physicians and patients in the Telepsychiatry pro gramme at the University of Antioquia's Faculty of Medicine in the first 12 months after its implementation in eight towns across Antioquia. Methodology: A descriptive study involving the evaluation of 111 patients during the programme's first year. An instrument was designed to evaluate patients' satisfaction and the Technology Acceptance Model (TAM) was used to evaluate the health professionals' satisfaction. Results: 111 patients were seen on 340 occasions. 70 out of the 111 patients (63.1%) were seen by Telepsychiatry at least twice in the first year of implementation. A sample of 38 patients (34%) was used to evaluate their experience, of which 94.7% said their problem had been solved and 100% were highly satisfied. Nine health professionals took part in the programme, who agreed that the technology was useful and easy to use. They also stated that they wanted to continue using it. Conclusion: Health systems across the globe have failed to provide an adequate response to the mental health burden. Therefore, strategies such as telepsychiatry are considered an ideal treatment modality to give patients living in remote locations the specialised attention that they need.
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Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Aplicação da Lei , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Suicídio Consumado/psicologia , COVID-19 , Colômbia , Humanos , Masculino , Pessoa de Meia-Idade , Quarentena/legislação & jurisprudência , SARS-CoV-2Assuntos
Humanos , Masculino , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Infecções por Coronavirus/prevenção & controle , Aplicação da Lei , Pandemias/prevenção & controle , Betacoronavirus , Suicídio Consumado/psicologia , Quarentena/legislação & jurisprudência , Colômbia , SARS-CoV-2 , COVID-19 , Pessoa de Meia-IdadeRESUMO
El síndrome Freemartin es un estado de intersexualidad de muchas de las hembras bovinas provenientes de parto múltiple heterosexual (macho - hembra). Éste se origina en la vida fetal entre los 30 y 40 días de gestación producto del intercambio transplacentario de células mediante anastomosis vasculares, presentándose fenómenos de quimerismo 60XX/XY en varios tejidos, y esterilidad consecuente. En el presente trabajo se tomaron 106 muestras de sangre de terneras provenientes de parto múltiple heterosexual, se realizó extracción de ADN de leucocitos y se buscó la amplificación del gen SRY asociado al cromosoma "Y" mediante PCR y lectura en gel de agarosa. 90 terneras (84.9%) de las 106 amplificaron SRY, verificando el quimerismo 60XX/XY, y 16 terneras (15.1%) que no amplificaron el gen, libres del síndrome quimérico y por lo tanto, aptas reproductivamente. El análisis citogenético realizado mediante cultivo de linfocitos demostró la presencia del cromosoma "Y" en linfocitos de hembras positivas a SRY y la ausencia del quimerismo en hembras SRY negativas. El análisis anatómico post mortem de tractos reproductivos de hembras positivas a SRY detectó anormalidades características del síndrome tales como, clítoris hipertrofiados y atresias ductales cervicales. El análisis histopatológico de placas de gónadas de estos animales evidenció la presencia de ovotestículos. El presente estudio confirma la utilidad de las técnicas de biología molecular como herramientas diagnósticas del síndrome, para el aprovechamiento de hembras de reemplazo al servicio del hato bovino.
Freemartin syndrome is a intersexuality condition developed in many of the female calfs born from heterosexual multiple calvings (male female). This originates in the fetal development between 30 and 40 days of gestation with transplacental exchange of cells through vascular anastomosis, occurring 60XX/XY chimerism in various tissues, and consequent sterility. In this paper was took blood samples from 106 female calves born from a multiple heterosexual calving. DNA was extracted from leucocytes and searched the SRY gene amplification associated with the Y chromosome by PCR and reading in agarose gel. 90 of 106 samples (84.9%) was amplified the SRY gene, verifying the 60XX/XY chimerism, and 16 samples (15.1%) that did not amplify the gene. Cytogenetic analysis using lymphocytes cell cultures showed the presence of Y chromosome in samples positive for SRY and absence of chimerism in SRY negative samples. The postmortem analysis of female reproductive tracts of SRY positive calves, shows anatomical abnormalities such as clitoris hypertrophia and cervical atresia. Histological examination of gonads of these animals confirmed the presence of ovotestis. This study confirms the usefulness of molecular biology techniques as diagnostic tools of the syndrome, for the use of replacement females in cattle.
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OBJECTIVE: To adapt and to validate the Montgomery-Åsberg Depression Rating Scale (MADRS) in Colombia. METHODS: Observational study for scale validation. Validity criteria were used to determine the severity cut-off points of the tool. Taking into account sensitivity and specificity values, those cut points were contrasted with ICD-10 criteria for depression severity. A a factor analysis was performed. The internal consistencY was determined with the same sample of patients used for the validity criteria. Inter-rater reliability was assessed by evaluating the 22 records of the patients that consented to a video interview. Sensitivity to change was established through a second application of the scale in 28 subjects after a lapse of 14 to 28 days. RESULTS: The study was performed in Bogotá, the tool was applied in 150 patients suffering from major depressive disorder. The cut-off point for moderate depression was 20 (sensitivity, 98%; specificity, 96%), and the cut-off point for severe depression was 34 (sensitivity, 98%; specificity, 92%). The tool appears as a unidimensional scale, which possesses a good internal consistency with (α=.9168). The findings of inter-rater reliability evaluation showed the scale as highly reliable (intraclass correlation coefficient=.9833). The instrument has a good sensitivity to change. CONCLUSIONS: The Colombian version of the Montgomery-Åsberg Depression Rating Scale has good psychometric properties and can be used in clinical practice and in clinical research in the field of depressive disorder.
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Transtorno Depressivo Maior/diagnóstico , Escalas de Graduação Psiquiátrica , Adulto , Idoso , Idoso de 80 Anos ou mais , Colômbia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e EspecificidadeRESUMO
Objetivo: Adaptar y validar la Montgomery-Åsberg Depression Rating Scale (MADRS) en el medio colombiano. Metodología: Estudio de tipo observacional para la validación de una escala. Se precisó la validez de criterio determinando los puntos de corte del instrumento a través de los valores de sensibilidad y especificidad de la gravedad de la enfermedad, al contrastarla con los criterios de la Clasificación Internacional de Enfermedades (CIE-10). Se realizó un análisis factorial de la escala; se determinó la consistencia interna del instrumento; se evaluó la reproducibilidad interevaluadores a través de la evaluación de 22 pacientes por cuatro investigadores diferentes, y se estableció la sensibilidad al cambio de la escala en 28 sujetos aplicando el instrumento tras un lapso de 14-28 días. Resultados: El estudio se llevó a cabo en la ciudad de Bogotá, donde se aplicó a 150 pacientes con diagnóstico de depresión mayor. El punto de corte para depresión moderada fue 20 (sensibilidad, 98%; especificidad, 96%) y para grave, 34 (sensibilidad, 98%; especificidad, 92%). Se evidenció que el instrumento es unidimensional y posee buena consistencia interna (α = 0,9168). Los hallazgos de las pruebas de confiabilidad interevaluadores demostraron que el instrumento es altamente confiable (coeficiente de correlación intraclase = 0,9833). El instrumento tiene buena sensibilidad al cambio. Conclusiones: La versión colombiana de la escala de evaluación de la depresión Montgomery-Åsberg tiene buenas propiedades psicométricas y se puede utilizar en la práctica clínica y en investigaciones relacionadas con el trastorno depresivo.
Objective: To adapt and to validate the Montgomery-Åsberg Depression Rating Scale (MADRS) in Colombia. Methods: Observational study for scale validation. Validity criteria were used to determine the severity cut-off points of the tool. Taking into account sensitivity and specificity values, those cut points were contrasted with ICD-10 criteria for depression severity. A factor analysis was performed. The internal consistency was determined with the same sample of patients used for the validity criteria. Inter-rater reliability was assessed by evaluating the 22 records of the patients that consented to a video interview. Sensitivity to change was established through a second application of the scale in 28 subjects after a lapse of 14 to 28 days. Results: The study was performed in Bogotá, the tool was applied in 150 patients suffering from major depressive disorder. The cut-off point for moderate depression was 20 (sensitivity, 98%; specificity, 96%), and the cut-off point for severe depression was 34 (sensitivity, 98%; specificity, 92%). The tool appears as a unidimensional scale, which possesses a good internal consistency with (α = .9168). The findings of inter-rater reliability evaluation showed the scale as highly reliable (intraclass correlation coefficient=.9833). The instrument has a good sensitivity to change. Conclusions: The Colombian version of the Montgomery-Åsberg Depression Rating Scale has good psychometric properties and can be used in clinical practice and in clinical research in the field of depressive disorder.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Psicometria , Análise Fatorial , Estudo de Avaliação , Transtorno Depressivo , Estresse Psicológico , Classificação Internacional de Doenças , Colômbia , Transtorno Depressivo Maior , Metodologia como AssuntoRESUMO
BACKGROUND: Extended-release (ER) paliperidone is an innovative atypical antipsychotic that allows minimal peak-to-through fluctuations with once-daily dosing. OBJECTIVE: To evaluate effectiveness, safety and tolerability of flexible, once-daily doses of paliperidone ER (3-12 mg/day) in patients with schizophrenia from Argentina and Colombia who had previously failed treatment with other antipsychotic agents. METHODS: The authors conducted a 6-month, open-label, prospective and multicentric study. Effectiveness was assessed with Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance scale (PSP). Other measures of effectiveness, safety and tolerability, were also conducted. RESULTS: Paliperidone ER 3-12 mg/day improved Positive and Negative Syndrome Scale (PANSS) total scores (primary endpoint) from baseline to study end (p < 0,001). In the PANSS total score, the mean change from baseline (83, 9 units) to end point (53,7 units) was significant (p < 0,001). Flexible doses of paliperidone ER demonstrated a ≥20% reduction in the PANSS total score (p<0.001) in almost two-thirds of patients. PSP mean change from baseline (52 units) to end point (85 units) was significant (p < 0,001). Secondary effectiveness assessments, as well as safety and tolerability measures, demonstrated favourable results throughout the study. CONCLUSIONS: Flexible doses of paliperidone ER over 6 months were effective, safe and well tolerated in patients with schizophrenia from Argentina and Colombia.
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An interview tool, Diagnostic Interview for Genetic Studies (DIGS 3.0), was translated into Spanish for application in studies of psychiatric disorders in Colombia. Two Spanish translations of the original English version of DIGS were prepared and back-translated into English. A review committee verified the linguistic and cultural equivalence of the translations. The evaluator and test-retest reliability were assessed calculating Cohen's kappa for samples of 65 and 91 patients respectively. DIGS proved valid in both appearance and content. The confidence interval (C.I.) was excellent for schizophrenia (kappa = 0.81, C.I. 95% = 0.68-0.93), bipolar disorder (kappa = 0.87, C.I. 95% = 0.75-0.99), major depressive disorder (kappa = 0.86, C.I. 95% = 0.70-1.00), and for a normal diagnosis (kappa = 0.65, C.I. 95% = 0.41-0.89); it was good for other psychiatric diagnosis (kappa = 0.65, C.I. 95% = 0.41-0.89) and poor for schizoaffective disorder (kappa = 0.37, C.I. 95% = -0.02-0.76). Test-retest reliability was excellent for all diagnoses (kappa > 0.8), except for "other psychiatric diagnoses" (kappa = 0.64, C.I. 95% = 0.31-0.96). The Spanish translation of the DIGS was comprehensible, with face and content validity, and good test-retest and evaluator reliability. This translation will be a useful tool for genetic studies of psychiatric disorders in Latin America, particularly where schizophrenia and affective disorders are involved.
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Testes Genéticos/métodos , Transtornos Mentais/diagnóstico , Escalas de Graduação Psiquiátrica/normas , Colômbia , Humanos , Idioma , Transtornos Mentais/genética , Reprodutibilidade dos Testes , TraduçãoRESUMO
Objetivo: validar la entrevista diagnóstica para estudios genéticos (DIGS 3.0) en Colombia. Métodos: se hicieron dos traducciones del inglés al español del DIGS y se hizo traducción en sentido inverso (al inglés) de cada una. Un comité de revisión verificó la equivalencia translingüística y transcultural. Se evaluó la confiabilidad examen-reexamen e interevaluador del DIGS 3.0 en 65 y 91 pacientes, respectivamente, mediante el cálculo de kappa de Cohen. Resultados: el DIGS 3.0 mostró ser comprensible, con validez de apariencia y de contenido. La confiabilidad interevaluador fue excelente para esquizofrenia (kapa=0,81, IC95%: 0,68-0,93), trastorno bipolar (kapa=0,87, IC95%: 0,75-0,99), trastorno depresivo mayor (kapa=0,86, IC95%: 0,7- 1) y ausencia de trastorno psiquiátrico (kapa=0,88, IC95%: 0,71-1); fue buena para otro diagnóstico psiquiátrico (kapa=0,65, IC95%: 0,41-0,89) y pobre para trastorno esquizoafectivo (kapa=0,37, IC95%: -0,02-0,76). La confiabilidad examen-reexamen fue excelente para todos los diagnósticos (kapa>0,8), excepto para otro diagnóstico psiquiátrico (kapa=0,64, IC95%: 0,31-0,96), donde fue buena. Conclusiones: la versión en español del DIGS para Colombia mostró comprensibilidad, validez de apariencia y de contenido, y confiabilidad examen-reexamen e interevaluador. Es una herramienta útil para estudios genéticos en esquizofrenia y en trastornos afectivos.
An interview tool, Diagnostic Interview for Genetic Studies (DIGS 3.0), was translated into Spanish for application in studies of psychiatric disorders in Colombia. Two Spanish translations of the original English version of DIGS were prepared and backtranslated into English. A review committee verified the linguistic and cultural equivalence of the translations. The evaluator and test-retest reliability were assessed calculating Cohens kappa for samples of 65 and 91 patients respectively. DIGS proved valid in both appearance and content. The confidence interval (C.I.) was excellent for schizophrenia (kappa=0.81, C.I. 95% = 0.68-0.93), bipolar disorder (kappa=0.87, C.I. 95% = 0.75-0.99), major depressive disorder (kappa=0.86, C.I. 95% = 0.70-1.00), and for a normal diagnosis (kappa=0.65, C.I. 95% = 0.41-0.89); it was good for other psychiatric diagnosis (kappa=0.65, C.I. 95% = 0.41-0.89) and poor for schizoaffective disorder (kappa=0.37, C.I. 95% = -0.02-0.76). Test-retest reliability was excellent for all diagnoses (kappa>0.8), except for "other psychiatric diagnoses" (kappa=0.64, C.I. 95% = 0.31-0.96). The Spanish translation of the DIGS was comprehensible, with face and content validity, and good test-retest and evaluator reliability. This translation will be a useful tool for genetic studies of psychiatric disorders in Latin America, particularly where schizophrenia and affective disorders are involved.