Depresión en San Carlos de Bariloche: estudio epidemiológico sobre prevalencia y uso de los servicios de salud mental / Depression in San Carlos de Bariloche: Epidemiological study of prevalence and use of mental health services

RESUMEN INTRODUCCIÓN pocos estudios han evaluado la prevalencia de depresión mayor (DM) en Argentina, y las estimaciones son muy disímiles. El objetivo de la presente investigación fue estimar la prevalencia de DM, la utilización de los servicios de salud y la relación con aspectos sociodemográficos en personas de 18-64 años de San Carlos de Bariloche, Argentina. MÉTODOS se utilizó la Escala de Depresión del Centro de Estudios Epidemiológicos (CESD-R) para evaluar DM en una muestra de 299 personas en 2017 La encuesta comprendió, además, preguntas sociodemográficas y consultó si la persona había visitado a un profesional y recibido tratamiento por problemas de depresión. RESULTADOS la prevalencia de DM fue 5,7% (IC95%: 3,3-8,9). La tasa fue mayor en los estratos de menor nivel socioeconómico. Solamente un 47,1% de los casos de DM habían visitado a un médico por problemas emocionales, nervios o salud mental, con una tasa menor en los estratos de menor nivel socioeconómico. Se encontró mayor prevalencia de DM entre los desempleados y las personas que no trabajaban ni buscaban trabajo. El consumo perjudicial de alcohol o dependencia alcohólica fue más frecuente en individuos con DM (17,6%) que entre aquellos que no la padecían (6,9%). DISCUSIÓN la prevalencia de DM encontrada es similar a la registrada a nivel nacional. Se destaca la importante brecha entre atención y tratamiento. Es necesario fomentar políticas de Salud Pública para acceder a instancias terapéuticas adecuadas con el fin de mejorar la calidad de vida de las personas.

ABSTRACT INTRODUCTION few studies have evaluated major depression (MD) prevalence in Argentina, and estimates are very variable. The goal of this research was to estimate prevalence of MD, health services utilization and relationship with socio-demographic factors in 18- to 64-year-old people from San Carlos de Bariloche. METHODS the Center for Epidemiologic Studies Depression Scale Revised (CESD-R) was used to assess MD in a sample of 299 people in 2017. The questionnaire also inquired about socio-demographic aspects, and asked if people had visited a health care provider and received treatment for depression. RESULTS MD prevalence was 5.7% (CI95%: 3.3-8.9). The rate was higher in lower socio-economic strata. Only 47.1% of MD cases had visited a health care provider for emotional, nervous or mental health problems, with lower rates in lower socio-economic strata. There was a higher risk of MD among unemployed people and those who were neither working nor seeking for a job. Risky alcohol consumption or dependency was more common among MD cases (17.6%) than among non-MD cases (6.9%). DISCUSSION the MD prevalence found is similar to that reported nationwide. The study highlights an important gap between service use and treatment. It is necessary to promote public health policies to provide adequate therapeutic resources with the purpose of improving the quality of life.

[A REVIEW ABOUT SPONTANEOUS MOVEMENTS DISORDERS IN SCHIZOPHRENIA]. / Una revisión sobre los Trastornos Espontáneos del Movimiento (TEM) en la esquizofrenia.

Spontaneous movements disorders are frequently observed in schizophrenia. Together with the negative and cognitive symptoms, they comprise manifestations more linked to the damage of this complex condition, although they are insufficient to make the diagnosis. When the psychotic symptoms express these phenomena, they have probably been causing deleterious effects for years. Within these intrinsic components, motor disorders are the most delayed, paradoxically, as a consequence of the progress of phar-macotherapy. Treatment with antipsychotics modified the clinical symptoms of schizophrenia by developing improvements in positive symptoms, disorganization and agitation, but also produced a change of another order, with the side effects that, many times, had difficulty in being distinguished from the pathology itself. Above all, the specific neuroleptics share to a greater or lesser extent of the production of extrapyramidal symptoms, classically expressed in motor alterations. Therefore, these abnormal movements are often mistakenly associated with antipsychotic medication in an exclusive manner, overshadowing primary motor manifestations.The objective of this work is to highlight the characteristics, importance and relationship with the conventional therapy of spon-taneous movements disorders in schizophrenia.

Depresión en San Carlos de Bariloche Estudio epidemiológico sobre prevalencia y uso de los servicios de salud mental / Depression in San Carlos de Bariloche: Epidemiological study of prevalence and use of mental health services

INTRODUCCIÓN: pocos estudios han evaluado la prevalencia de depresión mayor (DM) en Argentina, y las estimaciones son muy disímiles. El objetivo de la presente investigación fue estimar la prevalencia de DM, la utilización de los servicios de salud y la relación con aspectos sociodemográficos en personas de 18-64 años de San Carlos de Bariloche, Argentina. MÉTODOS: se utilizó la Escala de Depresión del Centro de Estudios Epidemiológicos (CESD-R) para evaluar DM en una muestra de 299 personas en 2017. La encuesta comprendió, además, preguntas sociodemográficas y consultó si la persona había visitado a un profesional y recibido tratamiento por problemas de depresión. RESULTADOS: la prevalencia de DM fue 5,7% (IC95%: 3,3-8,9). La tasa fue mayor en los estratos de menor nivel socioeconómico. Solamente un 47,1% de los casos de DM habían visitado a un médico por problemas emocionales, nervios o salud mental, con una tasa menor en los estratos de menor nivel socioeconómico. Se encontró mayor prevalencia de DM entre los desempleados y las personas que no trabajaban ni buscaban trabajo. El consumo perjudicial de alcohol o dependencia alcohólica fue más frecuente en individuos con DM (17,6%) que entre aquellos que no la padecían (6,9%). DISCUSIÓN: la prevalencia de DM encontrada es similar a la registrada a nivel nacional. Se destaca la importante brecha entre atención y tratamiento. Es necesario fomentar políticas de Salud Pública para acceder a instancias terapéuticas adecuadas con el fin de mejorar la calidad de vida de las personas

[Sublicinal depression: an overlooked problem]. / Depresión subclínica: un problema no visibilizado.

Subclinical depression is a worldwide spread disease with significant impact on health and life quality. The goal of this study is to assess its prevalence, service utilization, and to identify the most vulnerable groups in 18 to 64 years-old residents of San Carlos de Bariloche, Argentina. A survey was administered to a stratified sample of the study population. The CESD-R scale was applied to establish the diagnosis. Sociodemographic and health-care service utilization information was collected as well. The prevalence of subclinical depression was 10% (CI 95%: 6.9%-14.0%). A trend of higher prevalence was observed among younger subjects, and in lower socioeconomic neighborhoods. One third of subjects with subclinical depression had previously consulted a health professional and less than half of them had been correctly diagnosed. Early detection and treatment of subclinical depression is key to diminishing the associated disability and to prevent its evolution to major depression. It is necessary to implement early detection strategies, specifically directed to the most vulnerable groups: younger people and lower socioeconomic strata.

[Use of benzodiazepine in the Neuropsychiatric Hospital of Cordoba Province]. / Descripción del uso de Benzodiazepinas en el Hospital Neuropsiquiátrico Provincial de Córdoba.

From their introduction in the psychiatric clinic, benzodiazepines have meant a great advance in the treatment of numerous pathologies, due to their therapeutic effectiveness and safety. Despite the consensus that indicates the rational use of this medication, it is much too frequently that actual practice does not conform with said criteria. We believed it necessary to conduct a revision regarding the prescription of benzodiazepines in our institution. For that purpose, we carried out a retrospective study using 130 medical histories trough a three-year period, analyzing the indication and duration of benzodiazepine usage. Consequently, we are able to affirm that the use of benzodiazepine, in relation to diagnosis and duration of usage, is not made according to international guidelines.

Descripción del uso de Benzodiazepinas en el Hospital Neuropsiquiátrico Provincial de Córdoba. / [Use of benzodiazepine in the Neuropsychiatric Hospital of Cordoba Province.]

From their introduction in the psychiatric clinic, benzodiazepines have meant a great advance in the treatment of numerous pathologies, due to their therapeutic effectiveness and safety. Despite the consensus that indicates the rational use of this medication, it is much too frequently that actual practice does not conform with said criteria. We believed it necessary to conduct a revision regarding the prescription of benzodiazepines in our institution. For that purpose, we carried out a retrospective study using 130 medical histories trough a three-year period, analyzing the indication and duration of benzodiazepine usage. Consequently, we are able to affirm that the use of benzodiazepine, in relation to diagnosis and duration of usage, is not made according to international guidelines.

Descripción del uso de Benzodiazepinas en el Hospital Neuropsiquiátrico Provincial de Córdoba / [Use of benzodiazepine in the Neuropsychiatric Hospital of Cordoba Province.]

From their introduction in the psychiatric clinic, benzodiazepines have meant a great advance in the treatment of numerous pathologies, due to their therapeutic effectiveness and safety. Despite the consensus that indicates the rational use of this medication, it is much too frequently that actual practice does not conform with said criteria. We believed it necessary to conduct a revision regarding the prescription of benzodiazepines in our institution. For that purpose, we carried out a retrospective study using 130 medical histories trough a three-year period, analyzing the indication and duration of benzodiazepine usage. Consequently, we are able to affirm that the use of benzodiazepine, in relation to diagnosis and duration of usage, is not made according to international guidelines.