Mental telehealth in a public child and adolescent psychiatry unit during the pandemic: a qualitative implementation study. / Telesalud mental en una unidad pública de psiquiatría infanto-juvenil en pandemia: estudio cualitativo de implementación.

Background: The COVID-19 pandemic led to a prompt implementation of remote care, especially in mental health care. The evidence supporting this modality of care is still emerging, with few qualitative studies describing its implementation in Latin American countries. This study aims to understand the perspectives of therapists and patients regarding the use of telehealth in a child and adolescent mental health unit of a Chilean public service. Methods: This is a qualitative study. Two focus groups were defined with 14 professionals, and 16 in-depth interviews were conducted with users of an outpatient child and adolescent psychiatry unit. The data were analyzed using the grounded theory model. Results: In the group of therapists, four main categories emerged: background of mental telehealth, implementation, mental telehealth from the therapist's position, and projections. Three main categories emerged in the patient's group: implementation, evaluation of mental telehealth users, and projections. Conclusions: There are elements in common between the opinions of patients and therapists. Something to note within the patient's group is that, despite accepting remote care and recognizing its positive aspects, aside from the pandemic context, they prefer face-to-face or mixed care.

Antecedentes: La pandemia por COVID-19 generó una implementación súbita de las atenciones a distancia, especialmente en atenciones de salud mental. La evidencia que sustenta esta modalidad de atención es aún emergente, con escasos estudios cualitativos que representen su implementación en países latinoamericanos. El objetivo de este trabajo es conocer la perspectiva de terapeutas y de usuarios, respecto del uso de la telesalud en una unidad de salud mental infantil y de la adolescencia de un servicio público chileno. Métodos: Estudio cualitativo. Se establecieron dos grupos focales con 14 profesionales en total, y 16 entrevistas en profundidad con usuarios de una unidad ambulatoria de psiquiatría infanto juvenil.. Los datos se analizaron utilizando el modelo de teoría fundamentada. Resultados: En el grupo de terapeutas surgen cuatro categorías fundamentales; antecedentes de la telesalud mental, implementación, telesalud mental desde la posición del terapeuta y proyecciones. En el grupo de usuarios surgieron tres categorías principales: implementación, evaluación de los usuarios de la telesalud mental y proyecciones. Conclusiones: Existen elementos en común entre la opinión de los usuarios y terapeutas. Un elemento importante dentro del grupo de los usuarios es que, a pesar de aceptar la atención remota y reconocer aspectos positivos en esta, fuera del contexto de pandemia prefieren atenciones presenciales o mixtas.

Telesalud mental en una unidad pública de psiquiatría infanto-juvenil en pandemia: estudio cualitativo de implementación / Mental telehealth in a public child and adolescent psychiatry unit during the pandemic: a qualitative implementation study

Antecedentes La pandemia por COVID-19 generó una implementación súbita de las atenciones a distancia, especialmente en atenciones de salud mental. La evidencia que sustenta esta modalidad de atención es aún emergente, con escasos estudios cualitativos que representen su implementación en países latinoamericanos. El objetivo de este trabajo es conocer la perspectiva de terapeutas y de usuarios, respecto del uso de la telesalud en una unidad de salud mental infantil y de la adolescencia de un servicio público chileno. Métodos Estudio cualitativo. Se establecieron dos grupos focales con 14 profesionales en total, y 16 entrevistas en profundidad con usuarios de una unidad ambulatoria de psiquiatría infanto juvenil.. Los datos se analizaron utilizando el modelo de teoría fundamentada Resultados En el grupo de terapeutas surgen cuatro categorías fundamentales; antecedentes de la telesalud mental, implementación, telesalud mental desde la posición del terapeuta y proyecciones. En el grupo de usuarios surgieron tres categorías principales: implementación, evaluación de los usuarios de la telesalud mental y proyecciones. Conclusiones Existen elementos en común entre la opinión de los usuarios y terapeutas. Un elemento importante dentro del grupo de los usuarios es que, a pesar de aceptar la atención remota y reconocer aspectos positivos en esta, fuera del contexto de pandemia prefieren atenciones presenciales o mixtas.

Background The COVID-19 pandemic led to a prompt implementation of remote care, especially in mental health care. The evidence supporting this modality of care is still emerging, with few qualitative studies describing its implementation in Latin American countries. This study aims to understand the perspectives of therapists and patients regarding the use of telehealth in a child and adolescent mental health unit of a Chilean public service. Methods This is a qualitative study. Two focus groups were defined with 14 professionals, and 16 in-depth interviews were conducted with users of an outpatient child and adolescent psychiatry unit. The data were analyzed using the grounded theory model. Results In the group of therapists, four main categories emerged: background of mental telehealth, implementation, mental telehealth from the therapist's position, and projections. Three main categories emerged in the patient's group: implementation, evaluation of mental telehealth users, and projections. Conclusions There are elements in common between the opinions of patients and therapists. Something to note within the patient's group is that, despite accepting remote care and recognizing its positive aspects, aside from the pandemic context, they prefer face-to-face or mixed care.

The right to dream: A cross-sectional look at poverty alleviation programs.

Studies on social programs reveal the absence of a cross-sectional perspective capable of identifying common aspects that improve the living conditions of their participants while also contributing to poverty alleviation. To detect such elements, we examined the transformations in the experiences and meanings associated with poverty and its alleviation by conducting semistructured interviews and focus groups with participants and intervention team members that implemented six social programs in Chile and Peru. We conducted a descriptive and relational analysis guided by Grounded Theory, which revealed three overarching elements: notions of poverty, notions of the overcoming of poverty, and changes necessary for overcoming poverty. Lastly, based on a complex view of poverty and considering the contributions of community psychology, we propose that interventions in this field must create meaningful relational spaces that restore participants' objective and subjective rights, such as the right to dream.

Identification of Dynamic Patterns of Personal Positions in a Patient Diagnosed With Borderline Personality Disorder and the Therapist During Change Episodes of the Psychotherapy.

Personal positions and voices of a patient diagnosed with borderline personality disorder (BPD) and the therapist during long-term psychotherapy were studied aiming to find differences in the patterns formed in these aspects of subjectivity according to the level of elaboration of the change episodes achieved by the patient. This case study considered a stage of qualitative analysis where change episodes of the patient were traced through the Change Episodes Model. Later, through the Model of Analysis of Discursive Positioning in Psychotherapy (MAPP), the voices and personal positions of the patient and her therapist were identified in each of the change episodes. In the stage of quantitative analysis, dynamic patterns in the voices and personal positions were established, accounting for hypothetical attractors using the Space State Grid (SSG) technique in each of the three different levels of subjective elaboration that constitute the change episodes. The results established differentiated dynamic patterns in the change episodes, coherent with the patient's change process, and formation of propositive/reflective specific patterns as the patient evolved in the three different levels of subjective elaboration. The above suggests that a subjective transformation process is displayed, and this is manifested in the different voices and personal positions that emerged as the change episodes evolve. The identified dynamic patterns can be considered nonlinear and emergent subjective exchanges between the patient and the therapist throughout the psychotherapy.

Resultados en psicoterapia individual de adultos desde la perspectiva de los Sistemas Dinámicos: una revisión sistemática / Adult individual psychotherapy results from the Dynamic Systems perspective: a systematic review

Resumen: Existe un variado número de investigaciones que emplea nociones de la perspectiva de sistemas dinámicos (SD) para describir procesos de cambio en psicoterapia, conceptualizándolo como un sistema no lineal autoorganizado que presenta procesos emergentes y variaciones estructurales. Se realizó una revisión sistemática de la investigación en psicoterapia individual con pacientes adultos abordada desde esta perspectiva. La revisión se sustentó en la metodología PRISMA rastreando los principales conceptos de la perspectiva SD aplicados a la psicoterapia individual de adultos (entre 1997 y 2019), en los idiomas inglés y español, utilizando las bases de datos electrónicas PsycINFO y ProQuest. La selección final incluyó 34 estudios, tanto estudios de caso como estudios naturalistas, que abordaron diferentes variables de proceso y resultado de la psicoterapia. Los resultados resaltan la forma en que dichos conceptos ayudan a comprender el cambio de los pacientes como un proceso no lineal, destacando sus características de autoorganización, transiciones desde estados que generan sufrimiento psicológico a estados más saludables, y la formación de patrones emergentes en diferentes etapas de la psicoterapia. Se discuten algunos aspectos derivados (p.e. rol de la alianza, y de las intervenciones clínicas) que pueden ser abordados en el trabajo terapéutico.

Abstract: There is a diverse body of research that utilizes notions of the dynamical systems (DS) perspective to describe change processes in psychotherapy, understanding it as a non-linear self-organized system that presents emergent processes and structural variations. A systematic review of research in individual psychotherapy with adult patients addressed from this perspective has been carried out. The review was carried out supported by the PRISMA methodology tracking the main concepts of the DS perspective applied to individual psychotherapy of adults (between 1997 and 2019), in English and Spanish, using the electronic databases PsycINFO and ProQuest. The final selection included 34 studies, both case studies and naturalistic studies, covering different process and outcome variables of psychotherapy. The results highlight how such concepts help to understand patients' change as a nonlinear process, emphasizing its self-organizing characteristics, transitions from states that generate psychological distress to healthier states, and the formation of emergent patterns at different stages of psychotherapy. Some related aspects (e.g. role of the alliance, and of clinical interventions) that can be considered in the therapeutic work are discussed.

Internalización del estigma en personas LGB: Análisis de su impacto sobre la salud mental y la búsqueda de ayuda psicoterapéutica en Chile / Internalization of stigma in LGB people: Analysis of its impact on mental health and psychotherapeutic support in Chile

Resumen Antecedentes Estudios señalan que la internalización de creencias, prejuicios y actitudes existentes en la sociedad sobre las personas de la diversidad sexual afectan fuertemente su salud mental y podrían constituirse en una barrera de acceso a la ayuda psicológica y terapéutica en personas LGB. Objetivo Determinar la asociación entre los niveles de internalización de estigma sexual (ESI) en personas autoidentificadas como lesbianas, gay y bisexuales (LGB) con la presencia de malestar subjetivo, sintomatología depresiva y ansiosa, suicidalidad, y asistencia a psicoterapia. Método Un cuestionario aplicado de manera online que incluía preguntas sobre haber asistido o estar asistiendo a psicoterapia, además de escalas que evaluaban estigma sexual internalizado, malestar-bienestar subjetivo, depresión y suicidalidad fue respondido por 669 personas cisgenero autoidentificadas como lesbianas, gay y bisexuales. Resultados Los resultados muestran una asociación positiva entre el nivel de ESI en personas LGB con sus niveles de malestar subjetivo, sintomatología depresiva y ansiosa, y suicidalidad, y una asociación negativa con estar asistiendo o haber asistido a psicoterapia. Conclusiones Se discuten las implicancias de los resultados presentados para el desarrollo de intervenciones psicoterapéuticas culturalmente competentes para pacientes pertenecientes a la diversidad sexual y de género.

Abstract Background Studies indicate that the internalization of beliefs, prejudices and attitudes existing in society about sexual minorities strongly affect their mental health and could constitute a barrier to access to psychological and therapeutic support in LGB people. Objective To determine the association between levels of internalized sexual stigma (ISS) in self-identified lesbian, gay and bisexual (LGB) people with the presence of subjective distress, depressive and anxious symptoms, suicidality, and psychotherapy attendance. Methods An online questionnaire including questions on having attended or attending psychotherapy, as well as scales assessing internalized sexual stigma, subjective distress-subjective well-being, depression, and suicidality was completed by 669 cisgender self-identified lesbian, gay, and bisexual individuals. Results The results show a positive association between the level of ISS in LGB people with their levels of subjective distress, depressive and anxious symptomatology, and suicidality, and a negative association with being attending or having attended psychotherapy. Conclusions The implications of the results presented for the development of culturally competent psychotherapeutic interventions for patients belonging to sexual and gender diversity are discussed.

Sparks of psychotherapeutic change: How therapists understand moments of meetings' contribution to change in psychotherapy.

OBJECTIVE: : This study describes therapists' experience of moments of meeting with their patients in psychotherapy, and how these moments relate to the patient's change process. METHOD: 13 in-depth interviews conducted with therapists from different theoretical backgrounds were analyzed using Grounded Theory. RESULTS: Four categories were established: (1) Characteristics of moments of meeting, (2) Triggers of moments of meeting (3) Enabling conditions, and (4) Main effects of moments of meeting. A conceptual model was developed around an axial phenomenon that provides understanding on how moments of meeting contribute to the change process in psychotherapy, through the construction of shared relational knowing. DISCUSSION: : The value of moments of meeting for the therapeutic process is discussed and reflected upon, as well as their effect on changes regarding implicit relational knowing.

Care in social policies from a comprehensive perspective: A proposal to conceptualize and address it based on community and psychosocial praxis.

The literature establishes the importance of care in the context of situations leading to burnout. However, there are theoretical limitations that make it difficult to understand its role within the social area. The article presents a proposal to conceptualize and address care in social policies from a comprehensive perspective, based on the community praxis of psychosocial teams. Results came from evaluating a care intervention with 35 participants from three teams focused on homeless people and two teams that worked with relatives of prison inmates. Interviews and focus groups were held, which were then analyzed Grounded Theory methods. As for the questions "Who is being taken care of?" and "Who is in charge of providing care?," four instances were defined: Workers, teams, self-care, and joint care. The article discusses the scope and theoretical challenges of care, as well as the key role played by institutions in care in community-based professional praxis. In addition, the authors reflect on the importance of comprehensive care for community psychology in today's social interventions.

Adolescence and Suicide: Subjective Construction of the Suicidal Process in Young Gay and Lesbian Chileans.

The association between suicide risk and sexual minority status can be understood from the perspective of the social determinants of health, an approach that requires the development of culturally sensitive knowledge. The aim of this study was to characterize young gay and lesbian people's subjective construction of their experience of having lived and survived a suicidal process. Qualitative interviews were conducted and analyzed as products based on life events. In the participants' accounts, we identified hostile contexts associated with suicide, trajectories associated with gay/lesbian identification processes, and milestones related to victimization experiences as part of the intentionality and rationality of suicide.

Using the Generic Model of Psychotherapy to Develop a Culturally-Sensitive Approach to Psychotherapy With Sexual and Gender Minority Patients.

This article discusses how the Generic Model of Psychotherapy (Orlinsky and Howard, 1987) can help to organize the psychotherapy research and the knowledge in the field of psychotherapy for sexual and gender minority patients. The structure that this traditional model provides is a good foundation for research in this field, inasmuch as it stresses macrosocial aspects that determine the provision of psychotherapy and contextualize its outcomes. Each one of the main components offered by the Generic Model of Psychotherapy - Determinants, Processes, and Consequences - are specified for psychotherapy with LGBT patients and are illustrated with a selection of already existing research in the field of sexual minorities; they are also stress areas marked by knowledge gaps that require future developments. In addition, a set of questions are proposed to contribute to new studies, including the clinical implications that can be derived from this model.

Episodes of meeting in psychotherapy: an empirical exploration of patients' experiences of subjective change during their psychotherapy process.

This study aims to assess moments of meeting in psychotherapy -understood as moments of intense connectedness and intimacy, shared between patient and therapist during any therapeutic encounter that enable a spin in the therapy process- using a qualitative interview with patients who were undergoing or had finished psychological treatment. Micro-pehenomenological interviews were conducted with nine patients who were undergoing or had finished psychological treatment. Transcriptions of the interviews were subject to micro-phenomenological analysis. A general structure of episodes of meeting showing their temporal evolution was identified and divided into six consecutive phases. These findings suggest that episodes of meeting in psychotherapy are lived and remembered by patients in a significant way; they are emotionally charged and have a meaning for each participant. Also, emotional and nonverbal cues seem to be highly relevant features. Moments of meeting could be understood as implicit mechanisms that allow changes in the implicit relational domain.

Recognizing states of psychological vulnerability to suicidal behavior: a Bayesian network of artificial intelligence applied to a clinical sample.

BACKGROUND: This study aimed to determine conditional dependence relationships of variables that contribute to psychological vulnerability associated with suicide risk. A Bayesian network (BN) was developed and applied to establish conditional dependence relationships among variables for each individual subject studied. These conditional dependencies represented the different states that patients could experience in relation to suicidal behavior (SB). The clinical sample included 650 mental health patients with mood and anxiety symptomatology. RESULTS: Mainly indicated that variables within the Bayesian network are part of each patient's state of psychological vulnerability and have the potential to impact such states and that these variables coexist and are relatively stable over time. These results have enabled us to offer a tool to detect states of psychological vulnerability associated with suicide risk. CONCLUSION: If we accept that suicidal behaviors (vulnerability, ideation, and suicidal attempts) exist in constant change and are unstable, we can investigate what individuals experience at specific moments to become better able to intervene in a timely manner to prevent such behaviors. Future testing of the tool developed in this study is needed, not only in specialized mental health environments but also in other environments with high rates of mental illness, such as primary healthcare facilities and educational institutions.

Suicide risk configuration system in a clustered clinical sample: a generalized linear model obtained through the LASSO technique

Objective: To identify clinical and sociodemographic factors that increase or decrease suicidal risk in a clinical sample of subjects seeking mental health care. Method: A cross-sectional study was performed at three health centers in Santiago, Chile. The Parental Bonding Instrument (PBI), Depressive Experience Questionnaire (DEQ), Outcome Questionnaire (OQ-45.2), Reasons for Living Inventory (RFL), and State Trait Anger Expression Inventory (STAXI-2), in addition to a sociodemographic survey, were applied to 544 participants (333 with suicidal behavior and 211 without current suicidal behavior). Through hierarchical clustering analysis, participants were grouped by similarity regarding suicidal risk. Then, a regression analysis was performed using the Least Absolute Shrinkage and Selection Operator (LASSO) technique, and factors that decrease or increase suicide risk (SR) were identified for each cluster. Results: The resultant clusters were grouped mainly by the age of participants. The most important protective factor was having confidence in one's own coping skills in difficult situations. Relevant risk factors were major depressive disorder (MDD), poor anger management, and difficulties in interpersonal relationships. Conclusions: Suicidal risk manifests differently throughout the life cycle, and different types of bonds may protect from or increase risk of suicide.

"I couldn't change the past; the answer wasn't there": A case study on the subjective construction of psychotherapeutic change of a patient with a Borderline Personality Disorder diagnosis and her therapist.

BACKGROUND: Qualitative research has provided knowledge about the subjective experiences of therapists and patients regarding the psychotherapy process and its results. Only few studies have attempted to integrate both perspectives, considering the influence of a patient's characteristics and diagnosis in the construction of this experience. AIM: To identify aspects of psychotherapy that contribute to therapeutic change based on the experience of a patient and her therapist, and to construct an integrated comprehension of the change process of a patient with Borderline Personality Disorder. METHOD: A single case was used to carry out a qualitative analysis of follow-up interviews of the participants of a long-term psychotherapy. Two qualitative approaches were combined into a model entitled "Discovery-Oriented Biographical Analysis" to reconstruct an integrated narrative. RESULTS: This method yielded an integrated narrative organized into four "chapters" that reflect the subjective construction of both the patient's and the therapist's experience of psychotherapy in terms of meaning. DISCUSSION: The understanding of psychotherapy as a multilevel process, in which different themes occur and develop simultaneously, is discussed. From this perspective, psychotherapy can be characterized as a process that involves the recovery of trust in others through corrective emotional experiences and the construction of a shared implicit relational knowledge. Clinical or methodological significance of this article: Research on the subjective experiences of psychotherapy must consider both patient and therapist as privileged but always complementary witnesses of their interaction. In addition, it should be noted that the experience of studying this biographical reconstruction generates a space where research and practice converge. The analysis of participants' narratives provides fascinating windows into their perceptions of psychotherapy and the process of change (Safran, 2013); here, the researcher is not merely a advantaged observer or a good summarizer: He/she has the chance to imbue the psychotherapy with a new meaning by connecting it with a common set of knowledge and a body of socially shared experience.

Suicide risk configuration system in a clustered clinical sample: a generalized linear model obtained through the LASSO technique.

OBJECTIVE: To identify clinical and sociodemographic factors that increase or decrease suicidal risk in a clinical sample of subjects seeking mental health care. METHOD: A cross-sectional study was performed at three health centers in Santiago, Chile. The Parental Bonding Instrument (PBI), Depressive Experience Questionnaire (DEQ), Outcome Questionnaire (OQ-45.2), Reasons for Living Inventory (RFL), and State Trait Anger Expression Inventory (STAXI-2), in addition to a sociodemographic survey, were applied to 544 participants (333 with suicidal behavior and 211 without current suicidal behavior). Through hierarchical clustering analysis, participants were grouped by similarity regarding suicidal risk. Then, a regression analysis was performed using the Least Absolute Shrinkage and Selection Operator (LASSO) technique, and factors that decrease or increase suicide risk (SR) were identified for each cluster. RESULTS: The resultant clusters were grouped mainly by the age of participants. The most important protective factor was having confidence in one's own coping skills in difficult situations. Relevant risk factors were major depressive disorder (MDD), poor anger management, and difficulties in interpersonal relationships. CONCLUSIONS: Suicidal risk manifests differently throughout the life cycle, and different types of bonds may protect from or increase risk of suicide.

Estilos de personalidad dependiente y autocrítico: desempeño cognitivo y sintomatología depresiva / Dependent and self-critical personality styles: Cognitive performance and depressive symptomatology

Resumen El presente estudio explora la relación entre las dimensiones de personalidad dependiente y autocrítica, con los déficits emocionales, cognitivos y sociales asociados a la sintomatología depresiva. La muestra del estudio la conformaron 91 estudiantes universitarios pertenecientes a la Pontificia Universidad Católica de Chile y a la Universidad de Chile, con edades comprendidas entre los 18 y 24 años. Para explorar el estado emocional de los participantes se utilizaron los test Inventario de Depresión de Beck (BDI) y Depressive Experiences Question naire (DEQ). Con el fin de evaluar el desempeño cognitivo, se utilizaron: una tarea tipo Stroop y la prueba de Tiempo de Reacción Serial (SSRT), y para evaluar el nivel de mentalización, la tarea de reconocimiento facial Reading the Mind in the Eyes Task (RMET) de Baron-Cohen. Se encontraron correlaciones significativas entre las dimensiones dependencia y autocrítica, la sintomatología depresiva y el desempeño cognitivo de los participantes.

Abstract This study examines the relationship between the dependent and self-criticism Cognitive dimensions of personality with emotional, cognitive and social deficits associated with depres-sive symptoms. The sample included 91 college students, aged 18 to 24, from Pontificia Universidad Católica de Chile and Universidad de Chile. The Beck Depression Inventory (BDI) and the Depressive Experiences Questionnaire (DEQ) tests were used in order to explore the emotional state of the participants. A Stroop task and a Serial Reaction Time (SSRT) test were used in order to assess cognitive performance. In turn, the Reading the Mind in the Eyes Task (RMET) face recognition task, by Baron-Cohen, was used to assess the mentalising capacity. Sig nificant correlations were found between dependency and self-criticism dimensions, depressive symptoms and cognitive performance of the participant.

Vocalization-Silence Dynamic Patterns: A system for measuring coordination in psychotherapeutic dyadic conversations / Patrones Dinámicos de Vocalización-Silencio: un sistema para medir coordinación en conversaciones diádicas en psicoterapia

Abstract This paper presents the Vocalization-Silence Dynamic Patterns (VSDP) method for the analysis of coordination in psychotherapeutic conversation. The objectives of its development are to empirically account for vocal coordination patterns in dialogs and to examine the association between interactional coordination and positive relational outcomes. The VSDP method makes it possible to demonstrate that vocal activity is a nonverbal phenomenon entwined with and which influences the linguistic code. The analyses which can be carried out through this method are illustrated with real acoustic signals taken from psychotherapy segments. The VSDP method is discussed, considering its usefulness for psychotherapeutic research as well as the study of dyadic conversation within other scenarios.

Resumen Este trabajo presenta el método de Patrones Dinámicos de Vocalización-Silencio (PDVS) para el análisis de la coordinación en la conversación psicoterapéutica. Los objetivos de su desarrollo son dar cuenta empíricamente de los patrones de coordinación vocales en diálogos y examinar la asociación entre la coordinación interaccional y los resultados relacionales positivos. El método PDVS hace posible demostrar que la actividad vocal es un fenómeno no verbal entrelazado con y que influye en el código lingüístico. Los análisis que se pueden realizar a través de este método se ilustran con señales acústicas reales tomadas de segmentos de psicoterapia. El método PDVS es discutido teniendo en cuenta su utilidad para la investigación en psicoterapia, así como para el estudio de la conversación diádica dentro de otros escenarios.

Acute Mental Discomfort Associated with Suicide Behavior in a Clinical Sample of Patients with Affective Disorders: Ascertaining Critical Variables Using Artificial Intelligence Tools.

AIM: In efforts to develop reliable methods to detect the likelihood of impending suicidal behaviors, we have proposed the following. OBJECTIVE: To gain a deeper understanding of the state of suicide risk by determining the combination of variables that distinguishes between groups with and without suicide risk. METHOD: A study involving 707 patients consulting for mental health issues in three health centers in Greater Santiago, Chile. Using 345 variables, an analysis was carried out with artificial intelligence tools, Cross Industry Standard Process for Data Mining processes, and decision tree techniques. The basic algorithm was top-down, and the most suitable division produced by the tree was selected by using the lowest Gini index as a criterion and by looping it until the condition of belonging to the group with suicidal behavior was fulfilled. RESULTS: Four trees distinguishing the groups were obtained, of which the elements of one were analyzed in greater detail, since this tree included both clinical and personality variables. This specific tree consists of six nodes without suicide risk and eight nodes with suicide risk (tree decision 01, accuracy 0.674, precision 0.652, recall 0.678, specificity 0.670, F measure 0.665, receiver operating characteristic (ROC) area under the curve (AUC) 73.35%; tree decision 02, accuracy 0.669, precision 0.642, recall 0.694, specificity 0.647, F measure 0.667, ROC AUC 68.91%; tree decision 03, accuracy 0.681, precision 0.675, recall 0.638, specificity 0.721, F measure, 0.656, ROC AUC 65.86%; tree decision 04, accuracy 0.714, precision 0.734, recall 0.628, specificity 0.792, F measure 0.677, ROC AUC 58.85%). CONCLUSION: This study defines the interactions among a group of variables associated with suicidal ideation and behavior. By using these variables, it may be possible to create a quick and easy-to-use tool. As such, psychotherapeutic interventions could be designed to mitigate the impact of these variables on the emotional state of individuals, thereby reducing eventual risk of suicide. Such interventions may reinforce psychological well-being, feelings of self-worth, and reasons for living, for each individual in certain groups of patients.

[Suicide in lesbian, gay, bisexual and trans populations: systematic review of a decade of research (2004-2014)]. / Suicidio en poblaciones lesbiana, gay, bisexual y trans: revisión sistemática de una década de investigación (2004-2014).

UNLABELLED: Lesbian, gay, bisexual and trans (LGBT) populations have a high prevalence of suicide behaviors. AIM: To review the literature on suicide among LGBT populations. MATERIAL AND METHODS: A systematic review of the scientific literature published between 2004 and 2014 on suicidality among LGBT people was conducted. Forty-five articles were selected for a thematic analysis. RESULTS: The research on suicide among LGBT people has increased during the last decade. The vast majority of studies have been conducted in the U.S. and other English speaking countries. At the same time, in a great part, these studies have been published in journals specializing in mental health and public health of sexual minorities. In general, they provide a significant foundation on protective and risk factors for suicide as well as their epidemiology. CONCLUSIONS: The focus of research on suicide among LGBT populations is mainly exploratory. More attention on these at-risk groups is required from the suicide research community in order to provide useful evidence for prevention and development of focalized and effective interventions.

Suicidio en poblaciones lesbiana, gay, bisexual y trans: revisión sistemática de una década de investigación (2004-2014) / Suicide in lesbian, gay, bisexual and trans populations: systematic review of a decade of research (2004-2014)

Lesbian, gay, bisexual and trans (LGBT) populations have a high prevalence of suicide behaviors. Aim: To review the literature on suicide among LGBT populations. Material and Methods: A systematic review of the scientific literature published between 2004 and 2014 on suicidality among LGBT people was conducted. Forty-five articles were selected for a thematic analysis. Results: The research on suicide among LGBT people has increased during the last decade. The vast majority of studies have been conducted in the U.S. and other English speaking countries. At the same time, in a great part, these studies have been published in journals specializing in mental health and public health of sexual minorities. In general, they provide a significant foundation on protective and risk factors for suicide as well as their epidemiology. Conclusions: The focus of research on suicide among LGBT populations is mainly exploratory. More attention on these at-risk groups is required from the suicide research community in order to provide useful evidence for prevention and development of focalized and effective interventions.