Validez del cuestionario PHQ-2 para la detección de depresión en personal sanitario colombiano durante Covid-19 / Validity of the PHQ-2 questionnaire for the detection of depression in Colombian health personnel during Covid-19

RESUMEN: Introducción: La sintomatologia depresiva en profesionales de la salud asociado a crisis virales es de alta prevalencia a nivel global, siendo su detección una prioridad por lo cual, el objetivo de esta investigación fue analizar la validez convergente y consistencia interna del cuestionario de salud del paciente-2 (PHQ-2) en profesionales sanitarios. Método: Estudio eSalud donde se recopilaron datos transversales en línea (n=725), de 281 médicos generales, 237 médicos especialistas y 207 enfermeras durante la cuarentena colombiana, entre el 20 de abril y el 10 de agosto de 2020. Edad promedio 41,3 años (± 8,76). El 38,4% eran hombres (278) y el 61.6% mujeres (447). El 66.1% del personal sanitario atendió pacientes contagiados por coronavirus y el 33,9% no prestó estos servicios. Se administró la versión de 9 ítems del PHQ, validada en población colombiana junto a la versión de 2 ítems del PHQ. Resultados: Se encontró una alta correlación entre las escalas (r=.860, P<0.001), demostrando la validez convergente del PHQ-2 para medir la sintomatología depresiva. La consistencia interna del PHQ-2 fue adecuada, con un Alpha de Cronbach de 0.80 (I.C.= 0.76 - 0.83). Conclusiones: El PHQ-2 presenta adecuados estándares psicométricos de confiabilidad y validez, por lo que su rápida administración, fácil calificación e interpretación, lo convierte en un instrumento confiable y valido para la detección rápida, sin sobrecargas laborales, de los síntomas depresivos en médicos y enfermeras que atiendan o no pacientes en condiciones de brotes virales.

ABSTRACT Background: Depressive symptomatology in health professionals associated with viral crises is highly prevalent globally, being its detection a priority. Therefore, the objective of this research was to analyze the convergent validity and internal consistency of the Patient Health Questionnaire (PHQ-2) in healthcare professionals. Method: E-Health study where cross-sectional data was collected online (n = 725), from 281 general practitioners, 237 specialist doctors and 207 nurses during the Colombian quarantine, between April 20 and August 10, 2020. Average age 41.3 years (± 8.76). 38.4% were men (278) and 61.6% women (447). 66.1% of health personnel treated patients infected with coronavirus and 33.9% did not provide these services. The 9-item version of the PHQ was administered, validated in the Colombian population together with the 2-item version of the PHQ. Results: A high correlation was found between the scales (r = .860, P <0.001), demonstrating the convergent validity of the PHQ-2 to measure depressive symptomatology. The internal consistency of the PHQ-2 was adequate, with a Cronbach's Alpha of 0.80 (I.C. = 0.76 - 0.83). Conclusions: The PHQ-2 has adequate psychometric standards of reliability and validity, so its rapid administration, easy qualification and interpretation, makes it a reliable and valid instrument for the rapid detection, without work overload, of depressive symptoms in doctors and nurses whether or not they care for patients with viral outbreaks.

Propiedades psicométricas de la escala de salud mental positiva en Arequipa (Perú) / Psychometric properties of the positive mental health scale in Arequipa (Peru)

La salud mental positiva es un constructo complejo que está re-lacionado con el funcionamiento óptimo de la persona. Comprende un conjunto de cualidades orientadas al desarrollo del potencial del individuo. La Escala de Salud Mental Positiva es uno de los instrumentos más utiliza-dos paraevaluarlo, sin embargo, los antecedentes señalan inconsistencias respecto a su estructura interna. El objetivo del presente estudio fue anali-zar las propiedades psicométricas de la Escala de Salud Mental Positiva en Arequipa-Perú. Participaron 3933 personas, 50.3% fueron mujeres y 49.7% fueron varones, incluyendo desde adolescentes hasta adultos mayores. La evaluación mediante AFC de la estructura original evidenció índices de ajuste pobres, por lo que se tuvo que evaluar la dimensionalidad y proponer unanueva estructura. Para lo cual, se dividió a la muestra (n1= 1966 y n2= 1967). En la primera, se aplicó un AFE y en la segunda se valida mediante un AFC. Se hallaron tres factores y se concluye que tiene un buen ajuste (χ2(431) = 2473.378; CFI= .959; TLI= .956, RMSEA= .049; SRMR= .051). La consistencia interna mostró valores mayores a .81. Finalmente, se evaluó la equivalencia de la medición según el sexo, hallando que el instru-mento presenta invarianza de la medición.(AU)

Positive mental health is a complex construct that is related to the optimal functioning of the person. It comprises a set of qualities aimed at the development of the individual's potential. The Positive Mental Health Scale is one of the most used instruments to evaluate it, however, the antecedents indicate inconsistencies regarding its internal structure. The objective of this study was to analyze the psychometric properties of the Positive Mental Health Scale in Arequipa-Peru. 3,933 people partici-pated, 50.3% were women and 49.7% were men, including from adoles-cents to the elderly. The evaluation by CFA ofthe original structure showed poor fit indices, so the dimensionality had to be evaluated and a new structure had to be proposed. For which the sample is divided (n1= 1,966 and n2= 1,967). In the first, an EFA was applied and in the second, it is validated by means of a CFA. Three factors were found and it is con-cluded that it has a good fit (χ2(431) = 2,473.378; CFI= .959; TLI= .956, RMSEA= .049; SRMR= .051). The internal consistency showed values greater than .81. Finally, the equivalence of the measurement according to sex was evaluated, finding that the instrument presents measurement invariance.(AU)

Prevalence of Dementia and Associated Factors among Older Adults in Latin America during the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic has had a great impact on cognitive health in Latin American older adults, increasing the risk of cognitive impairment and dementia. Our objective was to analyze the prevalence of dementia and the associated factors in Latin American older adults during SARS-CoV-2 pandemic. METHODS: A multicentric first phase cross-sectional observational study was conducted during the SARS-CoV-2 pandemic. Five thousand two hundred and forty-five Latin American adults over 60 years of age were studied in 10 countries: Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Mexico, Peru, the Dominican Republic, and Venezuela. We used the telephone version of Montreal Cognitive Assessment, the "Alzheimer Disease 8" scale for functional and cognitive changes, and the abbreviated version of the Yesavage depression scale. We also asked for sociodemographic and lockdown data. All the evaluation was made by telephone. Cross-tabulations and χ2 tests were used to determine the variability of the prevalence of impairment by sociodemographic characteristics and binary logistic regression to assess the association between dementia and sociodemographic factors. RESULTS: We observed that the prevalence of dementia in Latin America is 15.6%, varying depending on the country (Argentine = 7.83 and Bolivia = 28.5%). The variables most associated with dementia were race and age. It does not seem to be associated with the pandemic but with social and socio-health factors. CONCLUSION: The prevalence of dementia shows a significant increase in Latin America, attributable to a constellation of ethnic, demographic, and socioeconomic factors.

Cognitive changes in patients with epilepsy identified through the MoCA test during neurology outpatient consultation.

INTRODUCTION: Epilepsy is a chronic neurological disorder that may occur alongside cognitive changes, with effects on multiple cognitive domains. OBJECTIVE: To compare the cognitive performance of patients with epilepsy and healthy controls through Montreal Cognitive Assessment (MoCA) during outpatient consultation at a reference diagnostic center in Colombia and analyze and the influencing factors. MATERIALS AND METHODOLOGY: One-hundred and four patients during neurology outpatient consultation in the city of Cartagena, Colombia, were assessed with the (MoCA) test, i.e., 54 people who consulted for headache and have not been diagnosed with epilepsy (NEP) and 50 with a diagnosis of epilepsy (EPs) according to the diagnostic criteria of the International League Against Epilepsy (ILAE). RESULTS: Significant differences were found in the total mean scores of the (MoCA) between (EPs) and (NPE) groups (t = 4.72; p < 0.01), particularly in attention (t = 3.22; p < 0.02) and memory (t = 5.04; p < 0.01) dimensions. Additionally, a significant association was observed between years of schooling and (MoCA) scores (p = 0,019) but not between socioeconomic level (p = 0,510), age (p = 0,452) and the frequency of seizures (p = 0,471). DISCUSSION: Patients with epilepsy show lower scores in several cognitive domains in respect of the control group. The (MoCA) has proven its appropriateness for cognitive screening in the contexts of clinical neurology outpatient consultation.

Afectación Neuropsicológica de la Función Ejecutiva en Pacientes con Insuficiencia Renal Crónica / Neuropsychological Impairment of Executive Function in Patients with Chronic Renal Failure

Resumen Objetivos: Analizar las diferencias en el rendimiento neuropsicológico de las funciones ejecutivas en pacientes tratados con Diálisis Peritoneal (DP) y Hemodiálisis (HD), además de valorar el nivel de afectación de las modalidades de tratamiento (DP vs HD) y las variables demográficas y clínicas sobre la respuesta cognitiva. Método: Estudio de corte transversal con muestreo no probabilístico que incluyó a 40 pacientes con insuficiencia renal crónica (IRC), divididos en dos grupos: 20 pacientes sometidos a DP y 20 a HD. Se utilizó una batería de pruebas neuropsicológicas que incluyeron El Test de Palabras y Colores de STROOP, la parte B del Trail Making Test (TMT), la Torre de Hanoi y el subtest de Dígitos Inversos de la Escala Wechsler; además de un cuestionario sobre variables clínicas y demográficas. Resultados: Se evidenciaron diferencias significativas en el número de errores del TMT B y el número de movimientos de la Torre de Hanoi, siendo los pacientes sometidos a DP quienes rindieron mejor que los pacientes sometidos a HD. Por otra parte, los años de escolaridad y la edad de los pacientes parecen tener un efecto significativo sobre el rendimiento en las pruebas neuropsicológicas utilizadas. Conclusiones: Los pacientes sometidos a DP tienen un mejor rendimiento en pruebas de función ejecutiva, pero dicho rendimiento es modulado por los años de escolaridad y la edad. Se discute el papel de la escolarización y la edad sobre el rendimiento neuropsicológico y las posibles causas de las diferencias encontradas en los grupos evaluados.

Abstract Objectives: Analyze differences in neuropsychological performance of executive functions in patients treated with peritoneal dialysis (PD) and hemodialysis (HD), and to assess the level of impact of treatment modalities (HD vs PD) and the demographic and clinical variables over cognitive function. Materials and methods: Cross-sectional study with non-probability sampling that included 40 patients with chronic renal failure (CRF) divided into two groups, 20 patients undergoing peritoneal dialysis and 20 in hemodialysis. It was used a battery of neuropsychological tests including test Stroop words and colors, Part B of the Trail Making Test (TMT), Tower of Hanoi, and indirect Digit subtest of the Wechsler scale; and a questionnaire on demographic and clinical variables. Results: Significant differences were found in the number of errors of TMT B and the number of movements of the Tower of Hanoi, with the PD patients who performed better than patients undergoing HD. Moreover, years of schooling and the age of patients appear to have a significant effect on performance in the neuropsychological tests used. Conclusions: Patients undergoing peritoneal dialysis have better performance on executive function tests, but this performance is modulated by the years of schooling and age. It is discussed the role of schooling and age on neuropsychological performance and possible causes of the differences in the evaluated groups.