[Mental disorders and their underdiagnosis in primary care]. / Los trastornos mentales y su infradiagnóstico en atención primaria.

Despite its high prevalence, mental disorders are often underdiagnosed. OBJECTIVE: To determine the magnitude of the underdiagnosis mental disorders and its associated characteristics. METHODOLOGY: A descriptive cross-sectional study performed in Lanzarote (2011) on 310 patients selected by cluster random sampling. A self-completed questionnaire was used that contained the General Health Questionnaire-28, as well as structured interview using the Mini International Neuropsychiatric Interview to confirm the diagnosis of mental disorder. The current diagnosis registered in the DRAGO-AP electronic medical record was also recorded. RESULTS: Of the 75 patients detected with the interview, 14 (18.67%) had a diagnosis recorded in the medical record (sensitivity=0.19; IC 95% CI; 0.09-28). The positive predictive value of being in the medical record was 0.56. With respect to sensitivity, only the "number of visits made to the health centre in the last 3 months" was significantly higher in the group of patients also with a diagnosis of any mental disorder in the medical record (5 vs. 2.77; p=.002). CONCLUSIONS: There is an important underdiagnosis of the mental disorders in our environment. More visits to the health centre are associated with this diagnosis.

Prevalencia, rasgos de personalidad y microambiente en adolescentes consumidores de cannabis / Prevalence, personality features and microenvironment cannabis consumers adolescents

OBJETIVOS. Conocer la prevalencia del consumo de cannabis en adolescentes, así como su asociación con rasgos de la personalidad, disfunción familiar y otras variables. SUJETOS Y MÉTODOS. Estudio descriptivo, en una muestra de 1.568 adolescentes de 12 a 18 años de los Institutos de Educación Secundaria del área de salud de Lanzarote, elegidos mediante muestreo por conglomerados. Como instrumento de medida se empleó un cuestionario autoadministrado de 41 ítems, que incluía 19 sobre la forma de pensar, sentir o actuar. RESULTADOS. Cuarenta y nueve adolescentes (3,1%; IC 95%: 2,2-4) consumían habitualmente cannabis y 166 (10,6%; IC95%: 9,1-12,1) lo hacían esporádicamente. El consumo aumentaba con la edad y era más frecuente en los varones. El consumo esporádico o habitual de cannabis se asoció sobre todo con el consumo habitual de tabaco y/o alcohol, haber consumido cocaína alguna vez y haberse emborrachado 5 o más veces. Los consumidores habituales de cannabis tenían mayor prevalencia de síntomas depresivos (28,6%) (OR = 3,1 respecto a los no consumidores; p < 0,001), de disfunción familiar (27,1%) (OR = 10,5; p < 0,001) y era más frecuente en hijos de madres bebedoras habituales. El consumo habitual de cannabis se asoció a diferentes indicadores de personalidad, pero la OR de asociación fue superior en aquéllos relacionados con la conducta antisocial. CONCLUSIONES. El consumo de cannabis en los adolescentes es un problema de elevada magnitud, siendo más frecuente en los varones de mayor edad consumidores de tabaco y/o alcohol que alguna vez consumieron cocaína, así como en aquéllos con mayor número de borracheras (AU)

OBJECTIVES. To know the prevalence of the consumption of cannabis in adolescents, as well as its association with personality features, familial dysfunction and another variables. METHODS. Descriptive study, in a sample of 1568 adolescents of 12 to 18 years of high schools of Lanzarote health area, chosen through sampling by conglomerates. A questionnaire of 41 items, that included 19 items about way to think, feel or act, was used as measurement instrument. RESULTS. Forty-nine adolescents (3.1%; 95% CI: 2.2-4) consumed cannabis habitually and 166 (10.6%; 95% CI:9.1-12.1) did it sporadically. Consumption increased with the age and was more frequent in men. The sporadic or habitual consumption of cannabis associated mainly with habitual consumption of tobacco and/ or alcohol, to have consumed cocaine sometimes and to have intoxicated 5 or more times. The habitual consumers of cannabis had greater prevalence of depressive symptoms (28.6%) (OR = 3.1 respect to non-consumers; p < 0.001), of familial dysfunction (27.1%) (OR = 10.5; p < 0.001), and was more frequent in children of mothers habitual drinkers. The habitual consumption of cannabis associated to different personality indicators but the OR of association was superior in those related with antisocial conduct. CONCLUSIONS. The consumption of cannabis in adolescents is a problem of high magnitude, being more frequent in older men, the consumers of tobacco and/or alcohol, who have ever consumed cocaine, and in those with greater number of drunkenness (AU)

Riesgo de trastornos del comportamiento alimentario en adolescentes de un área de salud / Risk of eating behavior disorders in adolescents in a health area

OBJETIVOS. Conocer las características generales del riesgo de los trastornos del comportamiento alimentario (TCA) en los adolescentes de Lanzarote, fundamentalmente la prevalencia y su asociación con diferentes variables. MÉTODOS. Estudio descriptivo transversal sobre adolescentes de 12 a 19 años en los institutos de educación secundaria obligatoria de la isla. La técnica de muestreo fue el muestreo por conglomerados, la unidad muestral era el aula. El número de protocolos válidos fue de 1.122. Se empleó un cuestionario autoadministrado en el que se incluía el EAT-26 (Eating Attitudes Test). RESULTADOS. Un total de 204 adolescentes presentaron riesgo de TCA, lo que supuso un 18,2% (intervalo de confianza del 95% [IC 95%]: 15,94-20,46%), superior en las mujeres: el 21,9% frente al 13,8% (p < 0,001). El riesgo decrece con la edad desde el 36,8% a los 12 años hasta el 6,5% a los 18-19 años (p = 0,001). Este riesgo aumenta con el número de dietas de adelgazamiento realizadas el último año (p < 0,001), es mayor en aquellos insatisfechos con su cuerpo (p < 0,001) o que perciben que pesan mucho (p < 0,001) y disminuye con la frecuencia con que desayuna (p < 0,001). Sólo en las adolescentes hemos encontrado asociación significativa con el consumo de alcohol (p = 0,022) y con la práctica deportiva (p = 0,008). CONCLUSIONES. La prevalencia de adolescentes en riesgo de TCA es elevada y se atenúa con la edad, observándose una asociación de dicho riesgo fundamentalmente con el número de dietas realizadas. La asociación con el abuso de sustancias y la práctica deportiva se observa sólo en las chicas. Su reducción sólo se podría conseguir mediante programas de prevención en el ámbito escolar

OBJECTIVE: Know the general characteristics of risk of eating behavior disorders in adolescents of Lanzarote, basically the prevalence and their association with different variables. MATERIAL AND METHODS: Descriptive, cross-sectional study on 12 to 19 year old adolescents in obligatory secondary education institutes of the island. The sampling technique was sampling by clusters, the sample unit was the classroom. Valid protocol number was 1122. A self-applied questions in which EAT-26 was included, was used. RESULTS: A total of 204 adolescents had risk of EBD (eating behavior disorders). This means 18.2% (95% CI: 15.94%-20.46%), superior in women: 21.9% versus 13.8% (P < 0.001). Risk decreases with age from 36.8% at 12 years to 6.5% at 18-19 years (P = 0.001). This risk increases with number of weight losing diets done the last year (P < 0.001). It is greater in those unsatisfied with their body (P = <0.001) or who perceive that they weight a lot (P = <0.001) and decreases with frequency that they have breakfast (P < 0.001). We have only found a significant association of alcohol consumption (P = 0.022) and practicing sports (P = 0.008) in adolescents. CONCLUSIONS: Prevalence of adolescents at risk of EBD is elevated and lessens with age, observing an association of this risk basically with the number of diets carried out. Association with substance abuse and practicing of sports is only observed in girls. Its reduction can only be achieved with prevention programs in the school setting