Relación entre antecedente de maltrato en la niñez y comportamiento maltratador hacia los hijos. Itagüí, Colombia, 2012-2013 / Relationship Between the History of Abuse in the Childhood and Abusive Behaviour Towards Children. Itagüí, Colombia, 2012-2013

RESUMEN Introducción: Una de las experiencias que representan mayor riesgo para el desarrollo de cualquier sociedad es el maltrato infantil. A pesar de las graves consecuencias que derivan de esta forma de violencia, tiende a ser un fenómeno oculto y poco comprendido. La razón que los padres maltraten a sus hijos es una de las cuestiones que mayor interés ha suscitado en la investigación de este fenómeno. Objetivo: Determinar cómo se relaciona el antecedente de maltrato en la niñez de los adultos con el comportamiento maltratador dirigido a sus propios hijos. Métodos: Estudio transversal, a partir de fuente de información secundaria. Se incluyeron variables sociodemográficas, relacionadas con comportamientos violentos dirigidos a otras personas, factores prosociales y el uso de sustancias psicoactivas. A partir de esta población, se seleccionaron 2 grupos, padres maltratadores y no maltratadores de sus propios hijos. En ambos grupos se evaluó la frecuencia de diferentes factores que pudieran explicar la probabilidad de comportamiento maltratador de los adultos hacia sus hijos. Se analizó la asociación entre el comportamiento agresivo contra los propios hijos y el hecho de tener el antecedente de haber sufrido maltrato en la niñez. Como medida de asociación, se utilizó la odds ratio (OR) con su respectivo intervalo de confianza del 95% (IC95%) y un umbral de significación p < 0,05. Resultados: Se incluyó a 187 adultos; el 63,1% eran mujeres. La mediana [intervalo intercuartílico] de edad fue 38 [24-52] años. El comportamiento maltratador de los padres hacia sus hijos se asoció con: sexo femenino (OR = 2,23; IC95%, 1,13-4,40), agresión a la pareja (OR = 3,28; IC95%, 1,58-6,80), agresión a otras personas fuera de la familia (OR = 2,66; IC95%, 1,05-6,74), comportamiento prosocial (OR = 0,32; IC95%, 0,14-0,73) y rasgos de conducta disfuncionales (OR = 2,23; IC95%, 1,11-4,52). No se encontró asociación con el antecedente de maltrato infantil en la niñez (OR = 1,54; IC95%, 0,59-4,04). Conclusiones: El antecedente de los padres de maltrato en la niñez no se asoció con el comportamiento maltratador hacia sus hijos. Sí se asociaron otras formas de violencia dirigida a la pareja y agresión a personas no familiares, lo que indica que el maltrato de la niñez en la población estudiada se relaciona con otras expresiones de violencia familiar y social.

ABSTRACT Introduction: One of the experiences that represent the biggest risk for any society is child abuse. Despite the consequences of this form of violence, it tends to be a hidden and little understood phenomenon. The reason why parents mistreat their children has been one of the issues that has raised the most interest in the investigation of this phenomenon. Objective: To determine how the history of child abuse in adults is related to abusive behaviour directed at their own children. Methodology: A cross-sectional study, based on a source of secondary information. The study included sociodemographic variables, variables related to violent behaviours directed to other people, pro-social factors and the use of psychoactive substances. From this population, 2 groups were selected, parents who were abusive and parents who were not abusive towards their own children. In both groups the frequency of different factors that could explain the probability of abusive behaviour of the adults towards their children was evaluated. We analysed the association between aggressive behaviour against one's own children and having a history of child abuse. As a measure of association, the OR was used with its respective 95% confidence interval and P-value<.05. Results: 187 adults were included, 63.1% were women. The median [IQR] age was 38 [2452] years. The abusive behaviour of the parents towards their children was associated with: the female sex (OR = 2.23; 95%CI, 1.13-4.40), partner's aggression (OR = 3.28; 95%CI, 1.58-6.80), aggression towards other people outside the family (OR = 2.66; 95%CI, 1.05-6.74), pro-social behaviour (OR = 0.32; 95%CI, 0.14-0.73), and dysfunctional behavioural traits (OR = 2.23; 95%CI, 1.11-4.52). There was no association with the history of child abuse (OR= 1.54; 95%CI, 0.59-4.04). Conclusions: The history of abuse in the parents' childhood was not associated with abusive behaviour towards their children. Other forms of partner's violence and non-family violence were associated, suggesting that child abuse in the study population was related to other expressions of family and social violence.

Relationship Between the History of Abuse in the Childhood and Abusive Behaviour Towards Children. Itagüí, Colombia, 2012-2013. / Relación entre antecedente de maltrato en la niñez y comportamiento maltratador hacia los hijos. Itagüí, Colombia, 2012-2013.

INTRODUCTION: One of the experiences that represent the biggest risk for any society is child abuse. Despite the consequences of this form of violence, it tends to be a hidden and little understood phenomenon. The reason why parents mistreat their children has been one of the issues that has raised the most interest in the investigation of this phenomenon. OBJECTIVE: To determine how the history of child abuse in adults is related to abusive behaviour directed at their own children. METHODOLOGY: A cross-sectional study, based on a source of secondary information. The study included sociodemographic variables, variables related to violent behaviours directed to other people, pro-social factors and the use of psychoactive substances. From this population, 2 groups were selected, parents who were abusive and parents who were not abusive towards their own children. In both groups the frequency of different factors that could explain the probability of abusive behaviour of the adults towards their children was evaluated. We analysed the association between aggressive behaviour against one's own children and having a history of child abuse. As a measure of association, the OR was used with its respective 95% confidence interval and P-value<.05. RESULTS: 187 adults were included, 63.1% were women. The median [IQR] age was 38 [24-52] years. The abusive behaviour of the parents towards their children was associated with: the female sex (OR=2.23; 95%CI, 1.13-4.40), partner's aggression (OR=3.28; 95%CI, 1.58-6.80), aggression towards other people outside the family (OR=2.66; 95%CI, 1.05-6.74), pro-social behaviour (OR=0.32; 95%CI, 0.14-0.73), and dysfunctional behavioural traits (OR=2.23; 95%CI, 1.11-4.52). There was no association with the history of child abuse (OR=1.54; 95%CI, 0.59-4.04). CONCLUSIONS: The history of abuse in the parents' childhood was not associated with abusive behaviour towards their children. Other forms of partner's violence and non-family violence were associated, suggesting that child abuse in the study population was related to other expressions of family and social violence.

Costos asociados con la salud mental / Costs associated with mental health

Para todas las personas, la salud mental y física y el bienestar social son componentes vitales inextricablemente ligados. Con el creciente conocimiento sobre esta interdependencia, se puede aceptar de manera evidente que la salud mental es un pilar central en el bienestar general de los individuos, las sociedades y las naciones. La salud mental puede ser definida como el estado de bienestar que permite a los individuos desarrollar sus habilidades, afrontar el estrés normal de la vida, trabajar de manera productiva y fructífera, y hacer una contribución significativa a sus comunidades. No obstante, en la mayor parte del mundo, ni remotamente se le atribuye a la salud mental y los trastornos mentales la misma importancia que a la salud física. Por el contrario, la salud mental ha sido objeto de abandono e indiferencia. Las enfermedades mentales no son solo un problema creciente de salud pública, sino también un problema social y económico que afecta a individuos y familias en todo el mundo. La prevalencia de trastornos mentales, la magnitud de la discapacidad causada por estos trastornos y la utilización de los servicios de estos pacientes han sido bien estudiados en países desarrollados y actualmente comienza a ser una prioridad en los países en desarrollo.

For all people, mental and physical health and social well-being are vital components that are inextricably linked. With the growing understanding of this interdependence, it can be clearly accepted that mental health is a central pillar in the overall well-being of individuals, societies and nations. Mental health can be defined as the state of well-being that enables individuals to develop their abilities, cope with the normal stresses of life, work productively and fruitfully, and make a meaningful contribution to their communities. However, in most parts of the world, mental health and mental disorders are not remotely accorded the same importance as physical health. On the contrary, mental health has been the subject of neglect and indifference. Mental illness is not only a growing public health problem, but also a social and economic problem that affects individuals and families around the world. The prevalence of mental disorders, the extent of disability caused by these disorders, and the utilization of services by these patients have been well studied in developed countries and are now beginning to be a priority in developing countries.

Personal and Social Factors Associated with Major Depression Disorder, Medellín (Colombia), 2012 / Factores personales y sociales asociados al trastorno de depresión mayor, medellín (colombia), 2012

Resumen Introducción: actualmente más de 350 millones personas de todas las edades viven en el mundo con trastorno de depresión mayor, siendo este un problema común en la población general que por la persistencia y la severidad de los síntomas que presenta afecta las esferas personal y social de los individuos. Objetivo: determinar los factores personales y sociales asociados al trastorno de depresión mayor en la población de 13 a 65 años de edad de la ciudad de Medellín en el periodo 2011-2012. Materiales y métodos: se analizó la información obtenida en el Primer estudio de salud mental poblacional representativo de hogares para la ciudad de Medellín recopilada a través de entrevistas, realizadas con el World Health Organization Composite International Diagnostic Interview. Se tomaron 4.176 registros. El procesamiento de la información se realizó mediante el programa SPSS versión 21.0 (Licencia Universidad CES). Resultados: la prevalencia para el trastorno de depresión mayor anual en la ciudad de Medellín en el año 2012 fue de 4,1 %. Las mujeres presentaron 2,4 veces más el riesgo de estar afectadas por trastorno de depresión mayor en comparación a los hombres. Tener una percepción regular/mala sobre la salud mental representa un riesgo 6,0 veces mayor que tener una percepción muy buena/excelente; presentar un grado medio de resiliencia representa casi 2 veces más el riesgo de presentar trastorno de depresión mayor en comparación con los que presentan un grado alto de resiliencia, y no poder desahogarse con la familia representa un riesgo de 1,9 veces en comparación a los que sí pueden hacerlo. Conclusiones: los factores personales que se asocian al trastorno de depresión mayor son ser mujer, tener una regular o mala percepción sobre su propia salud mental, no hacer ejercicio, presentar un grado medio de resiliencia; mientras que entre los factores sociales asociados se destacaron aspectos relacionados con la familia como no poder desahogarse y que ésta constantemente realice demandas a sus integrantes.

Abstract Introduction: mental disorders are one of the major health problems worldwide, more than 350 million people of all ages are facing major depressive disorder; this is being a common problem in the general population and its persistence and harshness of the symptoms affect personal and social aspects of an individual. Objective: Determining personal and social facts associated to the major depression disorder, in a population aged from 13 to 65 years old, in Medellin city, during 2011-2012 years. Materials and methods: It was analyzed the information obtained in the First Population Mental Health Survey representative of households for Medellin city, collected through interviews and conducted in cooperation with the World Health Organization Composite International Diagnostic Interview. 4,176 records were taken. The information processing was performed using the SPSS software version 21.0 (License for use of CES University). Results: The prevalence for major depressive disorder in the city of Medellin in 2012 was 4.1 %. Women were 2.4 times more likely to be affected by major depressive disorder compared to men. Having a fair / poor perception of mental health represents a 6.0 higher risk than having a very good / excellent perception; Presenting an average degree of resilience would represents almost 2 times of the risk of having major depressive disorder compared to those with a high degree of resilience, and who are not able to relieve oneself with their family represents a risk of 1.9 times in comparison to those who can do it. Conclusions: personal factors associated with major depressive disorder include facts such as: being female, having fair or poor mental health perception, not exercising, having an average degree of resilience; while in terms of the social aspects, they were highlighted aspects related to family, as it is the case of not being heard and being demanded constantly by the family members.

Trastornos por abuso y dependencia de sustancias en población colombiana: su prevalencia y comorbilidad con otros trastornos mentales seleccionados / Substance use disorders in Colombia: prevalence and comorbidity with other mental disorders

Introducción: Poco se conoce sobre la prevalencia de los trastornos por abuso y dependencia de sustancias y su comorbilidad con otros trastornos psiquiátricos en Colombia. Objetivos: Calcular la prevalencia anual y de vida para uso y trastornos por abuso o dependencia de sustancias y su comorbilidad con trastornos del ánimo, ansiedad e impulsividad. Método: Analítico, a partir de la información de la Encuesta Nacional de Hogares, que para el diagnóstico de los trastornos psiquiátricos aplicó el CIDI-WHO a 3.896 adultos de 18 a 54 años de edad no institucionalizados y residentes en el área urbana. Resultados: La prevalencia anual para trastorno por uso de sustancias en los 12 meses anteriores fue de 0,7% y para alguna vez en la vida de 2,4%. En el grupo de trastornos de ansiedad, el estrés postraumático presentó la mayor fuerza de asociación. Entre los trastornos del estado del ánimo, el trastorno afectivo bipolar (TAB) I presentó la asociación más alta. Entre los trastornos del impulso, la asociación más fuerte se encontró con el trastorno de la conducta. Conclusión: Este estudio sugiere que existe una fuerte asociación entre los trastornos por uso de sustancias y otros trastornos psiquiátricos, como el síndrome de estrés postraumático, el TAB I y trastornos de la conducta. Estos resultados tienen gran importancia clínica y de salud pública...

Introduction: Little is known about the prevalence of drug use, abuse and dependence and its comorbility with DSM-IV mental disorders in the general population in Colombia. Objective: To estimate the lifetime and 12-month prevalence of comorbidities such as anxiety, mood, impulse control, and substance disorders in the Colombia National Comorbidity Survey. Method: Nationally representative face-to-face household survey conducted using a fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview with 3,896 respondents 18 to 54 years old. Results: the lifetime and 12-month prevalence of substance use disorders were 0.7% and 2.4%, respectively. An important contribution of this study is the assessment of the associations between substance use disorders and other psychiatric disorders studied. In the anxiety disorders group, posttraumatic stress had the strongest association with substance use disorders. Among mood disorders, bipolar I disorder had the highest association. Among the disorders of impulse, the strongest association found was with conduct disorder. Conclusion: There is a strong association between substance use disorders and other psychiatric disorders such as post-traumatic stress disorder, bipolar I disorder, and conduct disorder. These results have great clinical and public health relevance...