Estudio transcultural del EPT-C en terapeutas de orientación dinámica post-racionalistas chilenos y argentinos / Transcultural PST-Q study in chilean and argentinean psychodynamic and post-rationalist psychotherapists

Resumen Antecedentes El objetivo de este artículo es comparar el Estilo Personal del Terapeuta (EPT) en psicólogos clínicos de dos enfoques teóricos, cognitivo post-racionalista y psicodinámicos, provenientes de dos países: Chile y Argentina. Además, se analizó el efecto de las variables demográficas y profesionales sobre el EPT. Método Se trabajó con una muestra compuesta por 138 psicoterapeutas, 50% chilenos ( n =69) y 50% argentinos ( n =69). Tanto en la muestra de terapeutas chilenos como argentinos, el 50,7% ( n =35) se identificaron de orientación cognitivo post-racionalista y el 49,3% ( n =34) de orientación psicodinámica. Se utilizó como instrumento el Cuestionario de Estilo Personal del Terapeuta. Resultados Se encontraron puntajes superiores en las Funciones Expresiva e Instruccional en terapeutas de nacionalidad chilena, y en la comparación de psicodinámicos versus terapeutas post-racionalistas, se registraron diferencias en las cinco dimensiones del EPT. Por último, se compararon a los terapeutas de acuerdo con su nacionalidad y enfoque teórico, y se encontraron diferencias en las funciones Expresiva e Instruccional al comparar psicólogos psicodinámicos de Argentina y Chile. Conclusiones Se discuten las implicancias de estos resultados en función de estudios previos.

Abstract Background The purpose of this article is to compare the Personal Style of the Therapist (PST) in clinical psychologists of two different theoretical orientations, post-rationalist cognitive and psychodynamic, from two countries: Chile and Argentina. Additionally, the effects of demographic and professional variables on PST were analyzed. Methods A sample consisting of 138 psychotherapists, 50% Chilean ( n =69) and 50% Argentinean ( n =69) was used. In both Chilean and Argentinean samples, 50.7% ( n =35) identified as having a post-rationalist cognitive theoretical orientation and 49.3% ( n =34) had a psychodynamic orientation. The Personal Style of the Therapist Questionnaire was used as a measure instrument. Results Higher scores were also found in the Expressive and Instructional Functions among Chilean therapists, and in the comparison between the psychodynamic and post-rationalist cognitive orientations, differences were recorded in all five dimensions of PST. Lastly, therapists were compared according to their nationality and theoretical orientation, and differences in the Expressive and Instructional Functions were found when comparing psychodynamic psychologists from Argentina and Chile. Conclusion The implications of these results are discussed based on previous research studies.

Children's experience of physical harms and exposure to family violence from others' drinking in nine societies.

AIM: To study caregiver reports of children's experience of physical harm and exposure to family violence due to others' drinking in nine societies, assess the relationship of harm with household drinking pattern and evaluate whether gender and education of caregiver affect these relationships. METHOD: Using data on adult caregivers from the GENAHTO (Gender and Alcohol's Harm to Others) project, child alcohol-related injuries and exposure of children to alcohol-related violence (CAIV) rates are estimated by country and pooled using meta-analysis and stratified by gender of the caregiver. Households with and without heavy or harmful drinker(s) (HHD) are compared assessing the interaction of caregiver gender on the relationship between reporting HHD and CAIV, adjusting for caregiver education and age. Additionally, the relationship between caregiver education and CAIV is analysed with meta-regression. RESULTS: The prevalence of CAIV varied across societies, with an overall pooled mean of 4% reported by caregivers. HHD was a consistent correlate of CAIV in all countries. Men and women in the sample reported similar levels of CAIV overall, but the relationship between HHD and CAIV was greater for women than for men, especially if the HHD was the most harmful drinker. Education was not significantly associated with CAIV. CONCLUSION: One in 25 caregivers with children report physical or family violence harms to children because of others' drinking. The adjusted odds of harm are significantly greater (more than four-fold) in households with a heavy or harmful drinker, with men most likely to be defined as this drinker in the household.

The efficacy of adding short-term psychodynamic psychotherapy to antidepressants in the treatment of depression: A systematic review and meta-analysis of individual participant data.

PURPOSE: We examined the efficacy of adding short-term psychodynamic psychotherapy (STPP) to antidepressants in the treatment of depression by means of a systematic review and meta-analysis of individual participant data, which is currently considered the most reliable method for evidence synthesis. RESULTS: A thorough systematic literature search resulted in 7 studies comparing combined treatment of antidepressants and STPP versus antidepressant mono-therapy (n = 3) or versus antidepressants and brief supportive psychotherapy (n = 4). Individual participant data were obtained for all these studies and totaled 482 participants. Across the total sample of studies, combined treatment of antidepressants and STPP was found significantly more efficacious in terms of depressive symptom levels at both post-treatment (Cohen's d = 0.26, SE = 0.10, p = .01) and follow-up (d = 0.50, SE = 0.10, p < .001). This effect was most apparent at follow-up and in studies examining STPP's specific treatment efficacy. Effects were still apparent in analyses that controlled for risk of bias and STPP quality in the primary studies. CONCLUSIONS: These findings support the evidence-base of adding STPP to antidepressants in the treatment of depression. However, further studies are needed, particularly assessing outcome measures other than depression and cost-effectiveness, as well as examining the relative merits of STPP versus other psychotherapies as added to antidepressants.

The social location of harm from others' drinking in 10 societies.

AIMS: Survey data from 10 diverse countries were used to analyse the social location of harms from others' drinking: which segments of the population are more likely to be adversely affected by such harm, and how does this differ between societies? METHODS: General-population surveys in Australia, Chile, India, Laos, New Zealand, Nigeria, Sri Lanka, Thailand, United States and Vietnam, with a primary focus on the social location of the harmed person by gender, age groups, rural/urban residence and drinking status. Harms from known drinkers were analysed separately from harms from strangers. RESULTS: In all sites, risky or moderate drinkers were more likely than abstainers to report harm from the drinking of known drinkers, with risky drinkers the most likely to report harm. This was also generally true for harm from strangers' drinking, although the patterns were more mixed in Vietnam and Thailand. Harm from strangers' drinking was more often reported by males, while gender disparity in harm from known drinkers varied between sites. Younger adults were more likely to experience harm both from known drinkers and from strangers in some, but not all, societies. Only a few sites showed significant urban/rural differences, with disparities varying in direction. In multivariate analyses, most relationships remained, although some were no longer significant. CONCLUSION: The social location of harms from others' drinking, whether known or a stranger, varies considerably between societies. One near-commonality among the societies is that those who are themselves risky drinkers are more likely to suffer harm from others' drinking.

[Association of health-related quality of life and suicidal risk in adolescents: A cross-sectional study]. / Asociación entre la calidad de vida relacionada con la salud y riesgo suicida en adolescentes: estudio transversal.

INTRODUCTION: Health-related quality of life (HRQoL) deterioraton is a risk factor for suicide in adults, however, this aspect has been little studied in adolescents. OBJECTIVE: To evaluate the asso ciation between HRQoL (measured with EQ-5D-5L) and suicidal risk in adolescents and its capacity for cross-sectional detection of suicidal risk. PATIENTS AND METHOD: 128 adolescents (15-19 years old) from Puerto Aysen (Chile) responded to the EQ-5D-5L questionnaire, the Okasha Suicide Scale and two anchoring questions of imminent suicide risk. A suicide risk case was considered to have a > 5 score on the Okasha scale or the affirmative answer to one of the anchoring questions. The index value of EQ-5D-5L was calculated and Odds Ratios (ORs) were estimated with confidence intervals (95% CI), adjusted for confounders. Areas under the ROC curve (AUC-ROC) were calculated to assess the discriminatory performance of EQ-5D-5L. RESULTS: 21 (16.4%) adolescents were at suicidal risk. Controlling for confounders, the EQ-5D-5L dimensions associated with suicidal risk were pain/ discomfort (OR: 2.5; 95% CI 1.1-6.1) and anxiety/depression (OR: 2.2; 95% CI 1.3-3.6). The AUC- ROC for both dimensions was 85% (95% CI 0.75-0.91) and 81% for the EQ-5D-5L index value (95% CI 0.72-0.89). CONCLUSIONS: HRQoL could be a risk factor for suicide in adolescents and in this way, the EQ-5D-5L could help in searching for high risk and hidden cases of suicidal risk.

Asociación entre la calidad de vida relacionada con la salud y riesgo suicida en adolescentes: estudio transversal / Association of health-related quality of life and suicidal risk in adolescents: a cross-sectional study

INTRODUCCIÓN: El deterioro de la calidad de vida relacionada con la salud (CVRS) es un factor de riesgo de suicido en adultos; no obstante, poco se ha estudiado esta dimensión en adolescentes. OBJETIVO: Evaluar la asociación entre calidad de vida relacionada con la salud, medido con el EQ-5D-5L, y riesgo suicida en adolescentes y su capacidad de detección transversal de riesgo suicida. PACIENTES Y MÉTODO: 128 jóvenes (15-19 años) de la comuna de Puerto Aysén (Chile) respondieron transversalmente el EQ-5D-5L, la escala de suicidalidad de Okasha y dos preguntas de anclaje de riesgo in minente de suicidio. Se consideró como caso de riesgo suicida a un puntaje > 5 en la escala Okasha o la respuesta afirmativa a una de las preguntas de anclaje. Se calculó el valor índice con los perfiles de salud del EQ-5D-5L. Se estimaron Odds Ratios (OR's) con intervalos de confianza (IC95%), ajustando por confusores y se calcularon áreas bajo la curva ROC (AUC-ROC) para evaluar la capacidad de pesquisa del EQ-5D-5L. RESULTADOS: 21 (16,4%) adolescentes fueron considerados como casos de riesgo suicida. Controlando por confusores, las dimensiones del EQ-5D-5L que se asociaron con riesgo suicida fueron: dolor/malestar (OR: 2,5; IC95% 1,1-6,1) y ansiedad/depresión (OR: 2,2; IC95% 1,3-3,6). El AUR-ROC para ambas dimensiones fue del 0,85% (IC95% 0,75-0,91) y de 0,81% para el valor del índice del EQ-5D-5L (IC95% 0,72-0,89). CONCLUSIONES: La CVRS podría ser un factor de riesgo de suicidio en adolescentes; y el EQ-5D-5L que mide esta dimensión, podría ayudar a pesquisar futuros casos y casos ocultos de riesgo suicida.

INTRODUCTION: Health-related quality of life (HRQoL) deterioraton is a risk factor for suicide in adults, however, this aspect has been little studied in adolescents. OBJECTIVE: To evaluate the asso ciation between HRQoL (measured with EQ-5D-5L) and suicidal risk in adolescents and its capacity for cross-sectional detection of suicidal risk. PATIENTS AND METHOD: 128 adolescents (15-19 years old) from Puerto Aysen (Chile) responded to the EQ-5D-5L questionnaire, the Okasha Suicide Scale and two anchoring questions of imminent suicide risk. A suicide risk case was considered to have a > 5 score on the Okasha scale or the affirmative answer to one of the anchoring questions. The index value of EQ-5D-5L was calculated and Odds Ratios (ORs) were estimated with confidence intervals (95% CI), adjusted for confounders. Areas under the ROC curve (AUC-ROC) were calculated to assess the discriminatory performance of EQ-5D-5L. RESULTS: 21 (16.4%) adolescents were at suicidal risk. Controlling for confounders, the EQ-5D-5L dimensions associated with suicidal risk were pain/ discomfort (OR: 2.5; 95% CI 1.1-6.1) and anxiety/depression (OR: 2.2; 95% CI 1.3-3.6). The AUC- ROC for both dimensions was 85% (95% CI 0.75-0.91) and 81% for the EQ-5D-5L index value (95% CI 0.72-0.89). CONCLUSIONS: HRQoL could be a risk factor for suicide in adolescents and in this way, the EQ-5D-5L could help in searching for high risk and hidden cases of suicidal risk.

[RADAR: a program for the prevention of suicide in adolescents in the region of Aysen, Chile, preliminary results]. / El programa RADAR para la prevención del suicidio en adolescentes de la región de Aysén, Chile: resultados preliminares.

OBJECTIVE: We present the preliminary results of the implementation of RADAR: a community suicide prevention program in adolescents implemented in two high schools in a south region of Chile. METHOD: In a pilot study, during 2016, we implemented RADAR in two high schools of Puerto Aysen, in in the Region of Aysen of Chile. A total of 409 actors were trained (among students, school teachers, caregivers and health professionals) for the screening and referral of high suicide risk adolescents. RESULTS: Out of a total of 144 students who passed the RADAR screening systems, 29 cases were detected as suicide risk (20%) and 27 of them were opportunely referred to the Emergency Service of the Hospital of Puerto Aysen. In the second RADAR screening campaign, 3 months later, 90% of the cases no longer presented suicide risk. CONCLUSION: These results show the high proportion of ado lescents at risk of suicide who are not visible by the health system and the feasibility of implementing RADAR in the community as an effective suicide prevention intervention.

El programa RADAR para la prevención del suicidio en adolescentes de la región de Aysén, Chile: resultados preliminares / RADAR: a program for the prevention of suicide in adolescents in the region of Aysen, Chile, preliminary results

OBJETIVO: Dar a conocer los resultados preliminares del programa comunitario RADAR (Red para la Atención y Derivación de Adolescentes en Riesgo suicida). MÉTODO: Durante el 2016, RADAR fue implementado como prueba de concepto en dos colegios de Puerto Aysén de la Región de Aysén, Chile. Se capacitó un total de 409 participantes (entre alumnos, profesores de los colegios, apoderados y profesionales de la salud) para la pesquisa y derivación de adolescentes en riego de suicidio. RESULTADOS: De un total de 144 alumnos que pasaron los sistemas de pesquisa de RADAR, se detectaron 29 casos en riesgo suicida (20%) y 27 fueron derivados oportunamente al Servicio de Urgencia del Hos pital de Puerto Aysén. En la segunda campaña de pesquisa de RADAR, 3 meses después, el 90% de los casos ya no presentaba riesgo suicida. CONCLUSIÓN: Estos resultados muestran la alta proporción de adolescentes en riesgo suicida que no son visibilizados por el sistema de salud y la factibilidad de implementar RADAR en la comunidad como una intervención preventiva efectiva.

OBJECTIVE: We present the preliminary results of the implementation of RADAR: a community suicide prevention program in adolescents implemented in two high schools in a south region of Chile. METHOD: In a pilot study, during 2016, we implemented RADAR in two high schools of Puerto Aysen, in in the Region of Aysen of Chile. A total of 409 actors were trained (among students, school teachers, caregivers and health professionals) for the screening and referral of high suicide risk adolescents. RESULTS: Out of a total of 144 students who passed the RADAR screening systems, 29 cases were detected as suicide risk (20%) and 27 of them were opportunely referred to the Emergency Service of the Hospital of Puerto Aysen. In the second RADAR screening campaign, 3 months later, 90% of the cases no longer presented suicide risk. CONCLUSION: These results show the high proportion of ado lescents at risk of suicide who are not visible by the health system and the feasibility of implementing RADAR in the community as an effective suicide prevention intervention.

Cuestionario de esquemas de Young CEY-S3: propiedades psicométricas en una muestra chilena mixta / Young Schema Questionnaire YSQ-S3: psychometric properties in an adult mixed sample from Chile

Resumen El Cuestionario de Esquemas de Young CEY-S3 es un instrumento que mide una taxonomía de 18 temas psicológicos centrales denominados esquemas desadaptativos tempranos, los cuales subyacerían a los trastornos de personalidad y a otros trastornos mentales. Esta investigación pretende estudiar las propiedades psicométricas del CEY-S3 en población chilena. Una muestra mixta de 85 pacientes de dos unidades de psiquiatría en hospitales públicos con diagnóstico de al menos un trastorno de la personalidad, y de 207 estudiantes universitarios no consultantes de dos universidades privadas. Los resultados muestran un buen ajuste para el modelo de 18 factores, una buena capacidad de discriminación por sexo y muestra clínica y no clínica, así como la consistencia interna de 17 de las 18 escalas es adecuada (α > 0.70). Estos resultados están en concordancia con los estudios de validación en distintas lenguas y culturas, lo que apoya su empleo en ámbitos clínicos o de investigación.

Abstract Young Schema Questionnaire, CEY-S3, is an instrument that measures a taxonomy of 18 central psychological themes called early maladaptive schemas, which would underlie personality disorders and other mental disorders. The aim of this investigation is analyze psychometric properties of CEY-S3 in a Chilean mixed sample of 85 patients with a diagnosis of personality disorders from two psychiatric units in public hospitals and a 207 university students sample from two private universities. The results show a good fit for the 18 factor model, a good ability to discriminate by sex and clinical and non-clinical sample, as well as the internal consistency of 17 of the 18 scales is adequate (α> 0.70). These results are in accordance with the validation studies in different languages and cultures, which supports their use in clinical or research fields.

Efectividad de la terapia conductual dialéctica en pacientes con trastorno de personalidad limítrofe en Santiago de Chile / Dialectical behavior therapy effectiveness for borderline disorder personality in Santiago de Chile

Resumen Más de la mitad de los pacientes con trastorno de personalidad limítrofe (TPL) han realizado al menos un intento suicida durante su vida y el 70% ha tenido al menos una hospitalización psiquiátrica. La presente investigación tiene como objetivo evaluar la efectividad de la Terapia Conductual Dialéctica (TCD) en pacientes con trastorno de personalidad limítrofe. Método: A través de un diseño observacional retrospectivo se evaluó el número de intentos suicidas, el número de hospitalizaciones psiquiátricas y el impacto clínico previo al tratamiento con TCD y posterior a éste. Se analizó la información disponible de 144 pacientes de la Unidad de Terapia Conductual Dialéctica del Servicio de Psiquiatría del Hospital del Salvador, de Santiago de Chile, entre los años 2006-2012. Los datos fueron recolectados a través de registros electrónicos, análisis de ficha clínica, mediante el cuestionario OQ-45.2 y contacto telefónico. Resultados: En cuanto a los resultados, a través del método estadístico de Wilcoxon, se demostró una diferencia significativa (p = 0,000) en el número de hospitalizaciones psiquiátricas pre y post tratamiento, una disminución (p = 0,000) del número de intentos suicidas posterior al tratamiento y mejoría en los puntajes del cuestionario OQ-45.2. Conclusión: La TCD fue efectiva en disminuir las 3 variables estudiadas en la población escogida.

More than half of patients diagnosed with borderline personality disorder have made at least one suicide attempt during their lifetime and 70% have been admitted to an inpatient psychiatric unit. This research aims to assess the effectiveness of Dialectical Behavior Therapy (DBT) in patients with borderline personality disorder. Methods: Using a retrospective observational design, the number of suicide attempt and psychiatric hospitalizations was measured pre and post DBT treatment. Data from 144 patients from Dialectical Behavior Therapy Unit at Hospital Salvador in Santiago de Chile was analyzed during 2006 and 2012. The data were gathered from electronic files of clinical records, a OQ-45.2 questionnaire and telephone calls. Results: The Wilcoxon statistical test showed a significant difference (p = 0.000) in the number of psychiatric hospitalizations pre and post-treatment, as well as a reduction (p = 0.000) in the number of post-treatment suicide attempt. Conclusion: The Dialectical Behavior Therapy was effective in the 3 studied events in the selected population.

A Multi-Country Study of Harms to Children Because of Others' Drinking.

OBJECTIVE: This study aims to ascertain and compare the prevalence and correlates of alcohol-related harms to children cross-nationally. METHOD: National and regional sample surveys of randomly selected households included 7,848 carers (4,223 women) from eight countries (Australia, Chile, Ireland, Lao People's Democratic Republic [PDR], Nigeria, Sri Lanka, Thailand, and Vietnam). Country response rates ranged from 35% to 99%. Face-to-face or telephone surveys asking about harm from others' drinking to children ages 0-17 years were conducted, including four specific harms: that because of others' drinking in the past year children had been (a) physically hurt, (b) verbally abused, (c) exposed to domestic violence, or (d) left unsupervised. RESULTS: The prevalence of alcohol-related harms to children varied from a low of 4% in Lao PDR to 14% in Vietnam. Alcohol-related harms to children were reported by a substantial minority of families in most countries, with only Lao PDR and Nigeria reporting significantly lower levels of harm. Alcohol-related harms to children were dispersed sociodemographically and were concentrated in families with heavy drinkers. CONCLUSIONS: Family-level drinking patterns were consistently identified as correlates of harm to children because of others' drinking, whereas sociodemographic factors showed few obvious correlations.

Distorsión de la imagen corporal en madres hacia sus hijos con sobrepeso u obesidad / Distorted body image of overweight or obese children among mothers

Pediatric obesity is a major public health problem in the country. The imbalance between caloric intake and expense has been recognized as a major contributing factor, however, despite many strategies to combat this pathology the results remain discouraging. The mother is an important treatment intermediary that can have a distorted motherly perception (DMP) about their child's nutritional status. The purpose of this study was to assess motherly perception of body image (MPBI) of their school-age children. We selected mothers with children between 7 and 17 years old from schools in Santiago, Chile. We assessed nutritional status with body index mass (BMI) and pubertal growth (Tanner) and compared MPBI with actual nutritional status. We observed that 54.8% of mothers of obese children and 78.3% of mothers of overweight children had DMP, estimating their child as thinner. DMP among mothers of overweight and obese children could affect treatment adherence and is a key point for intervention.

La obesidad pediátrica es un importante problema de salud pública en el país. El desequilibrio entre ingesta y gasto energético ha sido reconocido como la principal causa, pero pese a las múltiples estrategias para enfrentar esta patología los resultados continúan siendo desalentadores. La madre es un mediador importante en el tratamiento, pudiendo influir la distorsión de la imagen corporal (DIC) en el estado nutricional (EN) de sus hijos. El propósito de este trabajo fue evaluar en población escolar la percepción de la imagen corporal (PIC) de la madre hacia su hijo. Se seleccionaron madres con hijos con edades de 7 a 17 años de colegios de Santiago de Chile. Se determinó el EN según índice de masa corporal (IMC) y desarrollo puberal (Tanner). Se evaluó la PIC de la madre comparándose con lo real. Se observó que el 54,8% de las madres de niños obesos y el 78,3% de las madres de niños con sobrepeso presenta DIC, evaluando a su hijo más delgado. La DIC de la madre con su hijo con sobrepeso u obeso, podría repercutir en la escasa adherencia al tratamiento, siendo un punto clave en el cual intervenir.

Daño a niños y sus familias por el consumo de alcohol: resultados de una encuesta poblacional / Alcohol's impact on children and families: A population survey

Introducción Entre los adultos jóvenes el uso de alcohol es frecuente. Este consumo puede afectar negativamente a los menores que conviven con ellos, lo que constituye el objetivo de este estudio, que forma parte de un estudio colaborativo internacional financiado por Thai Health y la OMS. Sujetos y método Se describen los efectos negativos en niños, mediante un muestreo multietápico, aplicando una entrevista adaptada por los coinvestigadores a 1.500 chilenos de más de 18 años. Resultados Un total de 408 encuestados (27,2%) convivían con niños en el hogar. De ese total, el 10,5% estimó que el uso de alcohol de algún miembro de la familia había afectado negativamente a un niño. Los efectos más comunes fueron la violencia verbal (29,7%), presenciar violencia en el hogar (23,1%), ausencia de supervisión (18,7%), falta de dinero para proveer necesidades básicas (14,3%) y violencia física (7,7%). Casi en la mitad de los casos (46,3%) el bebedor era el padre o la madre, el padrastro/madrastra, o la pareja de la madre/padre, luego venían otros parientes (24,4%), un hermano/a del niño (4,9%) o un tutor del niño (2,4%). Conclusión Estos datos corroboran la observación clínica de que el consumo de alcohol es frecuente en los hogares. El consumo excesivo daña la salud física y mental no solo del bebedor sino también de quienes lo rodean. La violencia verbal y ser testigo de violencia grave en el hogar son frecuentes, así como los problemas económicos al no poder proveer sus necesidades básicas.

Introduction Alcohol is widely used among young families, and leisure time is frequently family time. Heavy alcohol consumption can adversely affect children. The objective of this work is to measure the harm to others in Chile. Subjects and method This descriptive and probabilistic study forms part of a collaborative research funded by Thai Health and WHO. The survey was adapted by co-researchers and applied to a nationally representative sample of 1500 Chileans over 18 years of age. Results A total of 408 respondents (27.2%) lived with children at home. Of this total, 10.5% felt that the use of alcohol by any member of the family had adversely affected a child. The most common adverse effects were verbal violence (29.7%), domestic violence (23.1%), unsupervised homes (18.7%), lack of money to provide basic needs of the child (14.3%), and physical violence (7.7%). Furthermore, in 6.6% of the cases child or family services agencies became involved. In almost half of the cases (46.3%), the drinker was the father, mother or step-parents. This was followed by other relatives (24.4%) and brothers (4.9%), or guardian of the child (2.4%). Conclusion These data support the clinical observation that alcohol is common in Chilean homes. Its consumption not only damages the physical and mental health of the drinker but also those around him. Verbal violence and witnessing serious physical violence are frequent issues, as well as economic problems that end up with the inability to provide the child with its basic needs.

Harm to others from alcohol: the role of socio-cultural variables / Daño a otros por causa del alcohol: la contribución de las variables socioculturales / Dano a outros causado pelo álcool: o papel das variáveis socioculturais

This paper describes the changes in alcohol research, from a traditional individual focus on individual bodily and mental effects, to a broader focus on harm to others. This shift has coincided with broader sequential definitions of the progression from normal through harmful alcohol dependence, both in the specialized epidemiological and also in the newer classificatory systems (DSM 5 and CIE 11 draft). After presenting updated global, regional and chilean data, an international collaborative Project (Alcohol Harm to Others, ATOH) is described, with the participating institutions: the local study and the chilean components of the research team, the conceptual framework of harm to others (families, children, women; neighbors, friends, co-workers; society at large). Ethical aspects and institutional approval are presented and the principal results outlined: socio-demographic data (with special focus on the role of gender, socio-economic level and religiosity/spirituality). The data is presented for the chilean sample, with examples from other participating countries. The complexity of the link between alcohol harm to others and religious and spiritual factors is studied comparing data from several of the participating countries, and the impact upon vulnerable populations, especially women and children. The discussion reviews some of the confounding and intervening factors that could influence the results. The conclusion about prevention and policy development closes the paper.

Este artículo describe los cambios en investigación sobre el abuso de alcohol, desde un enfoque tradicional sobre los efectos corporales y mentales en el individuo, a un enfoque amplio sobre el daño a otros. Este cambio ha coincidido con definiciones secuenciales más amplias de la progresión desde el estado normal a la dependencia dañina al alcohol, ambas en la especialidad de la epidemiología y también en los nuevos sistemas de clasificación (DSM 5 y propuesta de CIE 11). Después de presentar datos actualizados globales, regionales y chilenos, se describe un proyecto internacional colaborativo (Daño a Otros por Causa del Alcohol, ATOH) con las instituciones participantes: el estudio local y los componentes chilenos del equipo de investigación, la estructura conceptual de daño a otros (familias, niños, mujeres; vecinos, amigos, compañeros de trabajo; la sociedad en general). Se presenta la aprobación institucional y aspectos éticos, así como se delinean los principales resultados: datos sociodemográficos (con enfoque especial en el rol de género, nivel socioeconómico y espiritualidad/religiosidad). Se presentan los datos de la muestra chilena, con ejemplos de otros países participantes. Se estudia la complejidad del vínculo entre el daño por alcohol a otros y factores religiosos y espirituales, comparando datos de varios de los países participantes, y el impacto sobre poblaciones vulnerables, especialmente mujeres y niños. La discusión revisa algunos de los factores de confusión y de intervención que podrían influenciar los resultados. Se cierra el artículo con conclusiones sobre prevención y desarrollo de normativas.

Este artigo descreve as alterações na pesquisa do álcool, a partir de um foco individual tradicional sobre os efeitos orgânicos e mentais individuais, para um foco mais amplo sobre danos a outros. Essa mudança coincidiu com mais amplas definições sequenciais da progressão do normal através de dependência de álcool prejudiciais, tanto na epidemiologia especializada como nos sistemas classificatórios mais recentes (DSM 5 e CIE 11 minuta). Depois de apresentar dados atualizados globais, regionais e chileno, um projeto internacional colaborativo (Alcohol Harm to Others, ATOH) é descrito, com as instituições participantes: o estudo local e os componentes chilenos da equipe de pesquisa, o quadro conceitual do dano a outrem ( famílias, crianças, mulheres, vizinhos, amigos, colegas de trabalho, e sociedade em geral). Aspectos éticos e aprovação institucional são apresentados e os principais resultados delineados: dados sócio-demográficos (com especial destaque para o papel do sexo, nível socioeconômico e espiritualidade / religiosidade). Os dados são apresentados para a amostra chilena, com exemplos de outros países participantes. A complexidade da relação entre efeitos nocivos do álcool para os outros e fatores religiosos e espirituais é estudada comparando os dados de vários dos países participantes, bem como o impacto sobre populações vulneráveis, especialmente mulheres e crianças. A discussão revê alguns dos fatores de confusão e intervenientes que poderiam influenciar os resultados. A conclusão sobre a prevenção e desenvolvimento de políticas define o papel.

[Alcohol's impact on children and families. A population survey]. / Daño a niños y sus familias por el consumo de alcohol: resultados de una encuesta poblacional.

INTRODUCTION: Alcohol is widely used among young families, and leisure time is frequently family time. Heavy alcohol consumption can adversely affect children. The objective of this work is to measure the harm to others in Chile. SUBJECTS AND METHOD: This descriptive and probabilistic study forms part of a collaborative research funded by Thai Health and WHO. The survey was adapted by co-researchers and applied to a nationally representative sample of 1500 Chileans over 18years of age. RESULTS: A total of 408 respondents (27.2%) lived with children at home. Of this total, 10.5% felt that the use of alcohol by any member of the family had adversely affected a child. The most common adverse effects were verbal violence (29.7%), domestic violence (23.1%), unsupervised homes (18.7%), lack of money to provide basic needs of the child (14.3%), and physical violence (7.7%). Furthermore, in 6.6% of the cases child or family services agencies became involved. In almost half of the cases (46.3%), the drinker was the father, mother or step-parents. This was followed by other relatives (24.4%) and brothers (4.9%), or guardian of the child (2.4%). CONCLUSION: These data support the clinical observation that alcohol is common in Chilean homes. Its consumption not only damages the physical and mental health of the drinker but also those around him. Verbal violence and witnessing serious physical violence are frequent issues, as well as economic problems that end up with the inability to provide the child with its basic needs.

[The harm to others from drinking: A population study]. / Daño a terceros producido por el alcohol: resultados de un estudio poblacional en Chile.

BACKGROUND: Alcohol can harm both drinkers and their human environment. Most of research in Chile has focused on the drinker. This work focuses on the damage to others. Governmental expenditures due to drinking are estimated to quadruple the income earned through taxation. AIM: To report the results of a population survey conducted in Chile in 2013 to assess the harm done to others from drinking by a known or unknown drinker. MATERIAL AND METHODS: A household survey of a sample of 1500 subjects living in urban areas, predominantly over 50.000 inhabitants, was conducted by trained interviewers. RESULTS: A significant number of respondents reported that the effect of alcohol consumption by third parties was somewhat (18.7%) or very negative (14.8%). The most frequent negative effects were verbal abuse (37.4%), being bullied (17.4%), feeling fearful at home or in a private meeting (19.6%) and family problems (16.9%). CONCLUSIONS: About one third of Chileans surveyed have suffered negative effects due to alcohol consumption of a known or unknown drinker. This finding signals the need of designing public policies addressed to minimize or prevent collateral effects of drinking.

Daño a terceros producido por el alcohol: resultados de un estudio poblacional en Chile / The harm to others from drinking: A population study

Background: Alcohol can harm both drinkers and their human environment. Most of research in Chile has focused on the drinker. This work focuses on the damage to others. Governmental expenditures due to drinking are estimated to quadruple the income earned through taxation. Aim: To report the results of a population survey conducted in Chile in 2013 to assess the harm done to others from drinking by a known or unknown drinker. Material and Methods: A household survey of a sample of 1500 subjects living in urban areas, predominantly over 50.000 inhabitants, was conducted by trained interviewers. Results: A significant number of respondents reported that the effect of alcohol consumption by third parties was somewhat (18.7%) or very negative (14.8%). The most frequent negative effects were verbal abuse (37.4%), being bullied (17.4%), feeling fearful at home or in a private meeting (19.6%) and family problems (16.9%). Conclusions: About one third of Chileans surveyed have suffered negative effects due to alcohol consumption of a known or unknown drinker. This finding signals the need of designing public policies addressed to minimize or prevent collateral effects of drinking.

Suicidal risk, depression, and religiosity: a study of women in a general hospital in Santiago de Chile.

INTRODUCTION: The purpose of the present study is to compare the role of spiritual and religious beliefs in the prevention of suicidal risk among depressive women with suicidal ideation or attempts, treated in the psychiatric unit of a general hospital in Santiago de Chile (Servicio de Psiquiatría del Hospital del Salvador) between 2010 and 2011. METHOD: The relationship among severity of depression, suicidal risk, and religiosity is explored in women treated in Servicio de Psiquiatría del Hospital del Salvador. The sociodemographic and clinical characteristics of believers (n = 121) and nonbelievers (n = 22) were compared, and their global mental health was assessed, as well as their rating in scales for depression, anxiety, aggressivity, and impulsivity. RESULTS: Most of the patients self-reported to belong to Catholic or other Christian churches. There were few statistically significant differences between them and nonbelievers, who were younger, had more years of education, were more frequently employed, and lived alone or with their parents. When comparing the least religious and the most religious quartiles, there were no differences in the type of affective disorder, attendance to temples, or self-appraisal of religiosity. Nonbelievers had more history of previous suicidal attempts and had more relatives committing suicide. DISCUSSION: In a country where most of the population is believer, self-reported religiosity seems to have a nonsignificant association with suicidality and severity of depression. Our results could be biased given the small number of nonbelievers in the sample.

Validación concurrente para Chile de un cuestionario multidimensional de adaptación a la enfermedad para pacientes de una unidad de hematología intensiva / Concurrent validation a multidimensional adaptation questionnaire for Illness to patients in a intensive hematology unit in Chile

El objetivo de esta investigación fue adaptar y validar para Chile el Cuestionario Multidimensional de Adaptación a la Enfermedad para Pacientes Onco-hematológicos (CMAE-OH) en la Unidad de Hematología Intensiva de un hospital general de Santiago de Chile. Este instrumento diseñado en España, es semiestructurado, consta de ítems cualitativos y cuantitativos, que proporcionan información para intervención preventiva, evalúan bienestar psicológico y adaptación a la enfermedad en los pacientes hemato-oncológicos. La metodología de trabajo fue la validación de contenido realizada por un panel de expertos. La muestra total fue de 42 pacientes hospitalizados, con 62 por ciento de hombres y 38 por ciento de mujeres, entre 15 y 56 años de edad. Se comparan los índices de una muestra de Santiago de Chile con una muestra de Madrid a través de análisis factoriales e índice de confiabilidad. Tanto en Chile como en España la variable información sobre la enfermedad, que mide el nivel de conocimiento del diagnóstico, tratamiento y pronóstico, es la variable que presenta más alta correlación con la adaptación a la enfermedad...

The purpose of this research was to adapt and validate the “Cuestionario Multidimensional de Adaptación a la Enfermedad para Pacientes Onco hematológicos (CMAE-OH)” in the Intensive Hematology Unit of a general hospital in Santiago de Chile. This instrument was designed in Spain as a semi-structured format with qualitative and quantitative items. These give information for preventive interventions, evaluate subjective well-being, and measure adaptation to hemato-oncologic diseases. The methodology consisted in content validation using an expert panel. The total simple were 42 inpatients, 62 percent males and 38 percent females, with ages between 15 and 56 years. The Santiago de Chile results are compared with a Madrid sample through a factor analysis. In Chile and in Spain the variable information of the disease, which measures the level of knowledge of the diagnosis, treatment and prognosis, is the variable that has the highest correlation with adaptation to the disease...

[Ignacio Matte Blanco, MD, and the development of psychiatry teaching to medical students]. / Docencia universitaria y psicoanálisis: Los aportes de Ignacio Matte Blanco.

Ignacio Matte Blanco had an important role in organizing the teaching of Psychiatry in medical school. In this paper we describe his training, that began as a physiologist, but turned into psychiatric and psychoanalysis in his formation in the United States and the United Kingdom during the forties. After returning to Chile, in the Chair of Psychiatry at the Faculty of Medicine of the Universidad de Chile he developed pioneering ideas about undergraduate teaching of psychiatry, that were exposed not only in Chile but to the Pan-American Health Organization. He advocated decreasing the time spent in lectures, and increase clinical practice and group dynamic experiences centered in the students. He insisted that teaching had to be focused in issues useful for general physicians and non psychiatric specialists, as well as in the need to extend the psychosocial curriculum to the internship. He also pointed to the need of increasing the humanistic formation of medical students. When Matte Blanco emigrated to Rome in 1966, his influences seemed to wane, since most of his disciples inverted exclamation markeft the Clínica Psiquiátrica Universitaria, where he taught. However, since the eighties, several of his viewpoints have been included in the medical curricula of Chilean schools of medicine.