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1.
Medicina (Kaunas) ; 57(2)2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33562800

RESUMEN

Background and objectives: The epidemiology of food allergy (FA) and food-dependent anaphylaxis remains unknown in Colombia. Our aim was to estimate by parent-report the prevalence of FA and food-dependent anaphylaxis in a Colombian population of schoolchildren. Materials and methods: A printed questionnaire was sent to parents of schoolchildren aged 5-12 years old from Medellín, Colombia in order to collect FA-related data. Results: Nine hundred and sixty-nine (969) parents returned the questionnaire with valid responses (response rate, 52.5%). The estimated prevalence rates (95% CI) were: adverse food reactions 12.79% (10.76-15.07), "perceived FA, ever" 10.93% (9.08-13.08), "physician-diagnosed FA, ever" 4.33% (3.14-5.81), "immediate-type FA, ever" 6.81% (5.30-8.58), "immediate-type FA, current" 3.30% (2.26-4.63), and food-dependent anaphylaxis 1.85% (1.10-2.92). The most frequently reported food allergens were milk (1.44%), fruits (0.41%), meat (0.41%), and peanut (0.3%). Sixty-one percent of "food-dependent anaphylaxis" cases sought medical attention, but only eleven percent of the cases reported the prescription of an epinephrine autoinjector. Conclusions: FA and food-dependent anaphylaxis are not uncommon among schoolchildren from Colombia. The prescription of epinephrine autoinjectors should be encouraged among health personnel for the optimal management of suspected cases of food-dependent anaphylaxis.

2.
Rev Colomb Psiquiatr ; 49(4): 262-270, 2020.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33328019

RESUMEN

INTRODUCTION: Traumatic events and violence are widespread public health problems. They do not have limits related to age, sex or socioeconomic level. The prevalence of mental disorders and sociodemographic characteristics were compared in the context of traumatic events and types of violence in the general population. MATERIALS AND METHODS: Observational prevalence study with a secondary information source, in the general population aged 13 to 65 years, selected at random. The interview was conducted using the Compositum International Diagnosis Interview which generates psychiatric diagnoses according to the DSM-IV. The variables included were traumatic events grouped into five categories: related to armed conflict, sexual violence, interfamily violence, other types of violence, traumas and some mental disorders. The prevalence of mental disorders was compared in the five categories of traumatic events. Statistical significance was defined as a p value of <0.05. RESULTS: Sexual and interfamily violence were more prevalent in women (p <0.05). In those under age 13, major depression related to armed conflict had a prevalence of 48.3%, with a significant difference from the other trauma groups (p=0.015). All prevalences for childhood-onset disorders showed significantly different prevalences compared with the group for violence related to armed conflict (p <0.05) and suicidal ideation was higher in the sexual violence group (p=0.006). DISCUSSION: High prevalences of mental disorders were found in people who had been exposed to traumatic events and violence. In those who experienced traumatic events related to armed conflict and sexual violence, higher prevalences of certain mental disorders were detected.

3.
Nutrients ; 12(9)2020 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-32899689

RESUMEN

The characteristics of food allergen labelling are relevant for avoiding accidental exposure to the allergens of interest but no Latin American country has evaluated these characteristics. Our aim was to evaluate the characteristics of food allergen labelling and precautionary allergen labelling (PAL) in six Latin American countries. All data were collected directly from the supermarkets surveyed. A total of 10,254 packaged food products were analyzed, of which 63.3% (n = 6494) and 33.2% (n = 3405) featured allergen labelling and/or PAL, respectively. Most products complied with local regulations (≥87.4% for both locally produced and imported). Thirty-three types of PAL statements were detected; the most frequent was "may contain traces of…" (35.1%). Countries without regulations on the characteristics of allergen labelling had two-fold more products that contained allergens in their ingredients lists but no food allergen labelling. The use of PAL in countries that regulate it (38.2%) was as high as that in countries without PAL regulations (19.2%-44.7%). The findings suggest that the lack of regulations for the characteristics of allergen labeling increases the risk of accidental exposure to allergens of interest. Our findings also suggest that beyond regulations, a scientific approach is required for minimizing and standardizing the use of PAL.

4.
Heliyon ; 6(4): e03809, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32382679

RESUMEN

Food packaging materials are commonly derived from petroleum that increases global contamination; this raises the interest to evaluate raw material from renewable sources such as whey protein for the development of packaging materials, especially to produce active films. This research aimed to evaluate whey protein-based film properties when natamycin, nanoemulsioned α-tocopherol, or both were added. An oil-in-water (O/W) nanoemulsion of antioxidant (α-tocopherol) was prepared by microfluidization technique. Four films were prepared with different levels of natamycin and nanoemulsified α-tocopherol and were characterized in terms of physicochemical, mechanical, optical-properties, water vapor barrier, FTIR, microstructure, antioxidant and antimicrobial activity. The natamycin, nanoemulsified α-tocopherol, or both did not modify the moisture content of the films. Moreover lead to a significant reduction of tensile strength and elastic modulus, while presenting growth in the elongation at break. Film opacity, the total color difference, the UV-Vis light barrier, and the water vapor permeability values increased when compounds were incorporated into the film. The microstructure studies showed uniformly distributed porosity throughout the films. The addition of nanoemulsioned α-tocopherol into whey protein-based films provoked antioxidant activity and the addition of natamycin produced films with effectivity against C. albicans, P. chrysogenum, and S. cerevisiae, allowing develop a material appropriate for use as active food packaging.

5.
J Food Sci Technol ; 57(4): 1523-1534, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32180649

RESUMEN

Potato snacks can be used as an ideal strategy for nutrient delivery, since they are one of the most widely consumed products in the world. Due to fried snacks are known to be a significant source of fat intake, consumption is changing towards healthier alternatives. The aim of this research is to evaluate the effect of vacuum impregnation and three dehydration techniques: heated air drying, freeze drying, and microwave vacuum drying of the potato snack that has been fortified with active components: calcium and vitamins C and E. Vacuum impregnation was evaluated using the response surface methodology that had a central composite experimental design with the following independent variables: vacuum pressure, vacuum stage time, and atmospheric stage time. The following were the dependent variables: fraction and volumetric deformation in the vacuum stage and at the end of the process and effective porosity. Finally, a sensorial analysis was carried out on the dehydrated potatoes. The results of the optimal vacuum impregnation process conditions were: a vacuum pressure of 77.3 kPa for 3.0 min followed by 4.0 min at atmospheric pressure. The content of calcium, vitamin C, and vitamin E in the impregnated potato were 956, 472, and 35 mg 100 g-1 dry solids, respectively. The highest retention of the active components in snacks was obtained by the combination of vacuum impregnation and the dehydration techniques in the following order: freeze drying, microwave vacuum drying, and then heated air drying. It can be concluded that the integration processes give an added value to potato snacks due to the increased content of the active components; additionally, the vacuum impregnation process together with microwave vacuum drying was the alternative that had the highest sensorial acceptability.

6.
Rev. colomb. psiquiatr ; 49(1): 53-61, ene.-mar. 2020. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1115642

RESUMEN

RESUMEN Introducción: La depresión es la comorbilidad psiquiátrica más común en las personas con epilepsia, lo cual les empeora el pronóstico y la calidad. A pesar de esto, frecuentemente no se reconoce este problema y cuando se diagnostica, el tratamiento es subóptimo. Objetivo: Realizar una revisión narrativa a partir de la literatura médica, buscando reco pilar información útil sobre la relación entre epilepsia y depresión y la mejor forma de diagnosticarla y tratarla. Resultados: Se identificaron revisiones de tema, revisiones sistemáticas, metanálisis, ensa yos clínicos y estudios de seguimiento en inglés y español, sin límite de tiempo, que incluyen aspectos epidemiológicos, clínicos, factores asociados, explicaciones etiológicas y aproxi maciones diagnósticas y terapéuticas de la depresión comórbida con la epilepsia. Conclusiones: La relación entre epilepsia y depresión es compleja. Alguna evidencia científica disponible indica la posibilidad de una relación bidireccional, que podría explicarse a partir de mecanismos etiopatogénicos comunes. A pesar de la alta prevalencia de la depresión entre los pacientes epilépticos, los clínicos siguen identificando escasamente este trastorno mental. Para mejorar esto, se cuenta con instrumentos de fácil aplicación que permiten tamizar sistemáticamente a esta población de pacientes y contribuir de manera sustancial a hacer más visible el problema y procurar la mejora de la calidad de vida de estas personas.


ABSTRACT Introduction: Depression is the most common psychiatric comorbidity in people with epilepsy. It worsens the prognosis and quality of life of these patients. Despite this, depression is poorly diagnosed and when the treatment is given, it is frequently suboptimal. Objective: To perform a narrative review of the medical literature, seeking to collect useful information regarding the relationship between epilepsy and depression. Results: Narrative reviews, systematic reviews, meta-analyses, clinical trials, and follow-up studies were identified in English and Spanish with no time limit, including epidemiological, clinical, associated factors, etiological explanations, diagnostic and therapeutic approaches to comorbid depression in epilepsy. Conclusion: The relationship between epilepsy and depression is complex. The availa ble scientific evidence suggests the possibility of a bidirectional relationship that could be explained from common aetiopathogenic mechanisms. Despite the high prevalence of depression in epileptic patients, this mental disorder continues to be poorly identified by clinicians. To improve this, we have easy-to-apply instruments that routinely screen this patient population and contribute substantially to making the problem more visible and seek to improve the quality of life for this population.

7.
Rev Colomb Psiquiatr ; 49(1): 53-61, 2020.
Artículo en Inglés, Español | MEDLINE | ID: mdl-32081210

RESUMEN

INTRODUCTION: Depression is the most common psychiatric comorbidity in people with epilepsy. It worsens the prognosis and quality of life of these patients. Despite this, depression is poorly diagnosed and when the treatment is given, it is frequently suboptimal. OBJECTIVE: To perform a narrative review of the medical literature, seeking to collect useful information regarding the relationship between epilepsy and depression. RESULTS: Narrative reviews, systematic reviews, meta-analyses, clinical trials, and follow-up studies were identified in English and Spanish with no time limit, including epidemiological, clinical, associated factors, etiological explanations, diagnostic and therapeutic approaches to comorbid depression in epilepsy. CONCLUSION: The relationship between epilepsy and depression is complex. The available scientific evidence suggests the possibility of a bidirectional relationship that could be explained from common aetiopathogenic mechanisms. Despite the high prevalence of depression in epileptic patients, this mental disorder continues to be poorly identified by clinicians. To improve this, we have easy-to-apply instruments that routinely screen this patient population and contribute substantially to making the problem more visible and seek to improve the quality of life for this population.

8.
Rev. colomb. psiquiatr ; 48(4): 252-260, oct.-dic. 2019. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1098950

RESUMEN

RESUMEN La recuperación funcional en la esquizofrenia es un tema que genera gran atención no solo clínica, sino también económica y social. Hasta hace pocas décadas, los pacientes esquizofrénicos permanecían recluidos en instituciones psiquiátricas o asilos, sin esperanza de reintegrarse a la comunidad. Se realizó una revisión narrativa de la literatura científica relevante, con el objetivo de responder a preguntas clave en relación con la recuperación en la esquizofrenia. Los objetivos terapéuticos en esquizofrenia han cambiado sustancialmente, de un tiempo en el que se esperaba un discreto control de los síntomas psicóticos al momento actual, cuando los esfuerzos terapéuticos se encaminan a que una proporción de pacientes alcancen la recuperación funcional. La evidencia disponible indica que 1 de cada 7 pacientes con esquizofrenia puede lograr la recuperación funcional, lo que implica la remisión sintomática no como meta final del tratamiento, sino como la base que permitirá alcanzar un mejor funcionamiento social y cognitivo que se traduce en mejor calidad de vida. Esta visión esperanzadora para este importante trastorno mental hasta hace poco no se creía posible.


ABSTRACT Recovery in schizophrenia is a topic that generates not only major clinical attention but also a significant economic and social impact. Until seventy years ago, these patients remained held in psychiatric institutions or asylums, usually with no hope of reintegrating into the community. A narrative review of relevant literature was conducted in order to answer key questions regarding recovery in schizophrenia. Treatment objectives in schizophrenia have changed substantially: from expecting a modest control of psychotic symptoms to considering functional recovery as a possibility. Available evidence indicates that one in seven patients with schizophrenia will achieve functional recovery, which implies that remission of positive symptoms is not the ultimate goal of treatment but only a basis for better social and cognitive functioning that translates into better quality of life. This view until recently was not believed to be possible for this major mental disorder.

9.
Rev Colomb Psiquiatr ; 48(4): 252-260, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31779876

RESUMEN

Recovery in schizophrenia is a topic that generates not only major clinical attention but also a significant economic and social impact. Until seventy years ago, these patients remained held in psychiatric institutions or asylums, usually with no hope of reintegrating into the community. A narrative review of relevant literature was conducted in order to answer key questions regarding recovery in schizophrenia. Treatment objectives in schizophrenia have changed substantially: from expecting a modest control of psychotic symptoms to considering functional recovery as a possibility. Available evidence indicates that one in seven patients with schizophrenia will achieve functional recovery, which implies that remission of positive symptoms is not the ultimate goal of treatment but only a basis for better social and cognitive functioning that translates into better quality of life. This view until recently was not believed to be possible for this major mental disorder.


Asunto(s)
Calidad de Vida , Esquizofrenia/terapia , Psicología del Esquizofrénico , Humanos , Inducción de Remisión , Esquizofrenia/fisiopatología , Resultado del Tratamiento
10.
Rev. colomb. psiquiatr ; 48(3): 166-173, jul.-set. 2019. tab
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1058417

RESUMEN

RESUMEN La depresión perinatal es el episodio depresivo mayor que se inicia durante el embarazo o en las primeras 4 semanas posparto y genera importantes riesgos de salud para la madre y para el bebé. Se realiza un estudio descriptivo transversal a partir de 112 registros de mujeres embarazadas o en el posparto inmediato, a quienes se aplicó la escala de Edimburgo para depresión perinatal y se exploró la posible asociación con factores de riesgo psicosocial ocurridos en el último ario. La prevalencia de síntomas depresivos perinatales de importancia clínica usando la escala de Edimburgo fue del 22,36%. El modelo de regresión logística encontró asociación entre síntomas depresivos perinatales clínicamente significativos (escala de Edimburgo ≥ 12) y los siguientes factores psicosociales: finalización de la relación de pareja (OR = 6,26; IC95%, 1,91-20,49), dificultades económicas graves (OR = 6,61; IC95%, 1,86-23,45) y muerte de un familiar (OR = 3,79; IC95%, 1,12-12,74). En este estudio, 1 de cada 4 mujeres había roto con la pareja y tenía problemas económicos graves durante la gestación; además, 1 de cada 10 había sufrido la muerte de un ser querido en el último año. Estos hallazgos ofrecen la oportunidad de identificar precozmente algunos eventos psicosociales negativos como factores de riesgo de depresión perinatal, lo que permitiría dar acompañamiento y tratamiento oportuno a quienes lo requieran. © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España, S.L.U. Todos los derechos reservados.


ABSTRACT Perinatal depression is a major depression episode that starts during pregnancy and the postpartum period; and is an important cause of health risks in women and infants. A cross-sectional observational study was conducted with information from the records of 112 pregnant women or in the immediate postpartum period who were surveyed to determine the possible association between perinatal depressive symptoms and psychosocial factors occurring in the last year. The prevalence of clinically significant perinatal depressive symptoms using the Edinburgh scale was of22.36%. The logistic regression model found association between clinically significant perinatal depressive symptoms (score on the Edinburgh scale ≥12 and the following psychosocial factors: end of the couple's relationship (OR = 6.26; 95% CI, 1.91-20.49), severe economic problems (OR = 6.61; 95% CI, 1.86-23.45), and the death of a family member (OR = 3.79; 95% CI, 1.12-12.74). In this study one in four women had broken up with their partner and had severe economic problems during pregnancy, also one of ten had suffered the death of a loved one in the past year. These psychosocial factors were strongly associated with the presence of depressive symptoms with clinical importance. These finding offer the opportunity to consider psychosocial factors as a source of maternal stress that could be easily identified in the prenatal controls that pregnant women receive to identify women at risk of experiencing depressive symptoms in the perinatal period, which will enable appropriate treatment to be given to those who need it.

11.
Rev. colomb. psiquiatr ; 48(3): 174-181, jul.-set. 2019. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1058418

RESUMEN

RESUMEN Los trastornos neurológicos funcionales, antes llamados trastornos conversivos, son un problema clínico frecuente en los servicios de neurología y psiquiatría y en atención primaria. En las nuevas categorías diagnósticas se hace énfasis en las características positivas necesarias para el diagnóstico de este trastorno. Se realizó una revisión narrativa de la literatura médica para determinar las diferencias y las ventajas clínicas que la actual clasificación aporta al diagnóstico y el tratamiento de los trastornos neurológicos funcionales. Se identifican las diferencias conceptuales entre los trastornos conversivos y los trastornos neurológicos funcionales y las implicaciones de estos cambios en el abordaje clínico. La nueva propuesta diagnóstica para los trastornos neurológicos funcionales brinda la oportunidad de transformar un diagnóstico realizado a partir del descarte de otras afecciones en otro en el que se verifica la presencia de signos neurológicos que apuntan al trastorno y se pueden ensenar al paciente, y a partir de ellos, plantear estrategias de tratamiento.


ABSTRACT Functional neurological disorders, formerly referred to as conversion disorders, are a frequent clinical problem in neurology, psychiatry and primary care departments. In the new diagnostic categories, emphasis is placed on the positive characteristics necessary to diagnose this disorder. A narrative review of the scientific medical literature related to the subject was performed in order to determine the differences and advantages that the new classification of functional neurological disorders gives to doctors and patients. Historical, diagnostic, clinical and treatment concepts related to functional neurological disorders are reviewed. The conceptual differences between conversion disorders and functional neurological disorders and the implications of these changes in the clinical approach are identified. The new proposed diagnosis for functional neurological disorders provides the opportunity to transform a diagnosis made by ruling out other pathologies to a diagnosis where the presence of neurological signs suggestive of the disorder are verified and can be taught to the patient, and based on them, treatment strategies posed. © 2017 Asociacion Colombiana de Psiquiatria. Published by Elsevier España, S.L.U. All rights reserved.

12.
Rev Colomb Psiquiatr ; 48(3): 166-173, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31426919

RESUMEN

Perinatal depression is a major depression episode that starts during pregnancy and the postpartum period; and is an important cause of health risks in women and infants. A cross-sectional observational study was conducted with information from the records of 112 pregnant women or in the immediate postpartum period who were surveyed to determine the possible association between perinatal depressive symptoms and psychosocial factors occurring in the last year. The prevalence of clinically significant perinatal depressive symptoms using the Edinburgh scale was of 22.36%. The logistic regression model found association between clinically significant perinatal depressive symptoms (score on the Edinburgh scale ≥ 12 and the following psychosocial factors: end of the couple's relationship (OR=6.26; 95% CI, 1.91-20.49), severe economic problems (OR=6.61; 95% CI, 1.86-23.45), and the death of a family member (OR=3.79; 95% CI, 1.12-12.74). In this study one in four women had broken up with their partner and had severe economic problems during pregnancy, also one of ten had suffered the death of a loved one in the past year. These psychosocial factors were strongly associated with the presence of depressive symptoms with clinical importance. These finding offer the opportunity to consider psychosocial factors as a source of maternal stress that could be easily identified in the prenatal controls that pregnant women receive to identify women at risk of experiencing depressive symptoms in the perinatal period, which will enable appropriate treatment to be given to those who need it.


Asunto(s)
Depresión Posparto/epidemiología , Depresión Posparto/psicología , Adolescente , Adulto , Estudios Transversales , Depresión Posparto/etiología , Femenino , Humanos , Persona de Mediana Edad , Prevalencia , Estrés Psicológico/complicaciones , Adulto Joven
13.
Rev Colomb Psiquiatr ; 48(3): 174-181, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31426920

RESUMEN

Functional neurological disorders, formerly referred to as conversion disorders, are a frequent clinical problem in neurology, psychiatry and primary care departments. In the new diagnostic categories, emphasis is placed on the positive characteristics necessary to diagnose this disorder. A narrative review of the scientific medical literature related to the subject was performed in order to determine the differences and advantages that the new classification of functional neurological disorders gives to doctors and patients. Historical, diagnostic, clinical and treatment concepts related to functional neurological disorders are reviewed. The conceptual differences between conversion disorders and functional neurological disorders and the implications of these changes in the clinical approach are identified. The new proposed diagnosis for functional neurological disorders provides the opportunity to transform a diagnosis made by ruling out other pathologies to a diagnosis where the presence of neurological signs suggestive of the disorder are verified and can be taught to the patient, and based on them, treatment strategies posed.


Asunto(s)
Trastornos de Conversión/diagnóstico , Trastornos del Movimiento/diagnóstico , Enfermedades del Sistema Nervioso/diagnóstico , Humanos
14.
Rev. colomb. psiquiatr ; 48(2): 72-79, ene.-jun. 2019. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1042850

RESUMEN

RESUMEN Introducción: Se define como síntoma médicamente inexplicado los síntomas físicos de varias semanas de duración cuya adecuada evaluación médica no revele alguna enferme dad que los explique; cuando estos síntomas se tornan persistentes, llevan a exploraciones clínicas exhaustivas y múltiples intervenciones. Estos pacientes tienen un deterioro mayor, o al menos comparable en cuanto a funcionamiento físico, salud mental y percepción nega tiva de su salud, que los pacientes con múltiples enfermedades médicas crónicas; tienen significativamente más eventos estresantes vitales (abuso psicológico, físico y/o sexual) y más probabilidades de cumplir criterios diagnósticos de ansiedad y depresión. Objetivo: Caracterizar sociodemográfica y psiquiátricamente un grupo de pacientes identi ficados en atención primaria con síntomas médicamente inexplicados. Métodos: Estudio descriptivo transversal de pacientes de 18-70 años, a quienes se aplicó el PHQ-15, el PHQ-9 y el PHQ para ansiedad y una encuesta diseña para la investigación. Resultados: Se analizó a 36 pacientes, el 94,4% mujeres, con una mediana de edad de 45 [20] años; el 33,3% de ellas estaban casadas y el 91,7% tenía hijos. El 55% tenía síntomas somáticos funcionales graves, el 77,8% tenía 1 o más trastornos somáticos funcionales y el 77,7% presentaba síntomas afectivos o ansiosos de relevancia clínica. El 25% de los pacientes reportaron antecedente de maltrato en la infancia; el 41,7%, maltrato de pareja, y el 41,6% había sido víctima del conflicto armado colombiano. Conclusiones: El principal hallazgo de este estudio fue que cerca de 8 de cada 10 pacientes cumplían criterios de un trastorno somático funcional con gran intensidad sintomática, y cerca de 3 de cada 10 pacientes cumplían criterios de 2 trastornos funcionales, la mayoría de estos pacientes sin otras enfermedades médicas de base. Además, en estos pacientes se encontró alta prevalencia de exposición a diferentes tipos de violencia a lo largo de la vida.


ABSTRACT Introduction: Medically unexplained symptoms are defined as physical symptoms that have been present for several weeks and that an adequate medical evaluation has not revealed any disease that explains them; when these symptoms become persistent, they lead to comprehensive clinical investigations and multiple interventions. These patients have a greater or at least comparable commitment to physical functioning, mental health, and negative health perception than patients with multiple chronic medical conditions; have significantly more stressful life events (psychological, physical and/or sexual abuse) and are more likely to meet diagnostic criteria for anxiety and depression. Objective: To characterize sociodemographic and psychiatric characteristics of a group of patients identified in primary care with medically unexplained symptoms. Methodology: A descriptive, cross-sectional study with patients from 18 to 70 years old who were given PHQ-15, PHQ-9 and PHQ for anxiety, and a survey designed for the study. Results: 36 patients were analysed, 94.4% women, median age 45 [RIC, 20] years-old, 33.3% married, 91.7% had children. 55% had severe functional somatic symptoms, 77.8% had one or more functional somatic disorders, and 77.7% had clinically relevant affective or anxiety symptoms. 25% of the patients reported a history of child abuse, 41.7% were mistreated by a partner, and 41.6% were victims of the Colombian armed conflict. Conclusions: The main finding of this study was that 8 out of 10 patients met criteria for a functional somatic disorder with great symptomatic severity and three out of ten patients met criteria for two functional disorders, most of these patients without otherbasic medical diseases. In addition, we found a high prevalence of exposure to different types of violence that these patients have been subjected to throughout their life.

15.
Rev Colomb Psiquiatr ; 48(2): 72-79, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30981330

RESUMEN

INTRODUCTION: Medically unexplained symptoms are defined as physical symptoms that have been present for several weeks and that an adequate medical evaluation has not revealed any disease that explains them; when these symptoms become persistent, they lead to comprehensive clinical investigations and multiple interventions. These patients have a greater or at least comparable commitment to physical functioning, mental health, and negative health perception than patients with multiple chronic medical conditions; have significantly more stressful life events (psychological, physical and/or sexual abuse) and are more likely to meet diagnostic criteria for anxiety and depression. OBJECTIVE: To characterize sociodemographic and psychiatric characteristics of a group of patients identified in primary care with medically unexplained symptoms. METHODOLOGY: A descriptive, cross-sectional study with patients from 18 to 70 years old who were given PHQ-15, PHQ-9 and PHQ for anxiety, and a survey designed for the study. RESULTS: 36 patients were analysed, 94.4% women, median age 45 [RIC, 20] years-old, 33.3% married, 91.7% had children. 55% had severe functional somatic symptoms, 77.8% had one or more functional somatic disorders, and 77.7% had clinically relevant affective or anxiety symptoms. 25% of the patients reported a history of child abuse, 41.7% were mistreated by a partner, and 41.6% were victims of the Colombian armed conflict. CONCLUSIONS: The main finding of this study was that 8 out of 10 patients met criteria for a functional somatic disorder with great symptomatic severity and three out of ten patients met criteria for two functional disorders, most of these patients without other basic medical diseases. In addition, we found a high prevalence of exposure to different types of violence that these patients have been subjected to throughout their life.


Asunto(s)
Ansiedad/epidemiología , Depresión/epidemiología , Síntomas sin Explicación Médica , Violencia/estadística & datos numéricos , Adolescente , Adulto , Anciano , Ansiedad/diagnóstico , Colombia , Estudios Transversales , Depresión/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Escalas de Valoración Psiquiátrica , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Adulto Joven
16.
Rev. colomb. psiquiatr ; 48(1): 17-25, ene.-mar. 2019. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1013956

RESUMEN

RESUMEN Introducción: Una de las experiencias que representan mayor riesgo para el desarrollo de cualquier sociedad es el maltrato infantil. A pesar de las graves consecuencias que derivan de esta forma de violencia, tiende a ser un fenómeno oculto y poco comprendido. La razón que los padres maltraten a sus hijos es una de las cuestiones que mayor interés ha suscitado en la investigación de este fenómeno. Objetivo: Determinar cómo se relaciona el antecedente de maltrato en la niñez de los adultos con el comportamiento maltratador dirigido a sus propios hijos. Métodos: Estudio transversal, a partir de fuente de información secundaria. Se incluyeron variables sociodemográficas, relacionadas con comportamientos violentos dirigidos a otras personas, factores prosociales y el uso de sustancias psicoactivas. A partir de esta población, se seleccionaron 2 grupos, padres maltratadores y no maltratadores de sus propios hijos. En ambos grupos se evaluó la frecuencia de diferentes factores que pudieran explicar la probabilidad de comportamiento maltratador de los adultos hacia sus hijos. Se analizó la asociación entre el comportamiento agresivo contra los propios hijos y el hecho de tener el antecedente de haber sufrido maltrato en la niñez. Como medida de asociación, se utilizó la odds ratio (OR) con su respectivo intervalo de confianza del 95% (IC95%) y un umbral de significación p < 0,05. Resultados: Se incluyó a 187 adultos; el 63,1% eran mujeres. La mediana [intervalo intercuartílico] de edad fue 38 [24-52] años. El comportamiento maltratador de los padres hacia sus hijos se asoció con: sexo femenino (OR = 2,23; IC95%, 1,13-4,40), agresión a la pareja (OR = 3,28; IC95%, 1,58-6,80), agresión a otras personas fuera de la familia (OR = 2,66; IC95%, 1,05-6,74), comportamiento prosocial (OR = 0,32; IC95%, 0,14-0,73) y rasgos de conducta disfuncionales (OR = 2,23; IC95%, 1,11-4,52). No se encontró asociación con el antecedente de maltrato infantil en la niñez (OR = 1,54; IC95%, 0,59-4,04). Conclusiones: El antecedente de los padres de maltrato en la niñez no se asoció con el comportamiento maltratador hacia sus hijos. Sí se asociaron otras formas de violencia dirigida a la pareja y agresión a personas no familiares, lo que indica que el maltrato de la niñez en la población estudiada se relaciona con otras expresiones de violencia familiar y social.


ABSTRACT Introduction: One of the experiences that represent the biggest risk for any society is child abuse. Despite the consequences of this form of violence, it tends to be a hidden and little understood phenomenon. The reason why parents mistreat their children has been one of the issues that has raised the most interest in the investigation of this phenomenon. Objective: To determine how the history of child abuse in adults is related to abusive behaviour directed at their own children. Methodology: A cross-sectional study, based on a source of secondary information. The study included sociodemographic variables, variables related to violent behaviours directed to other people, pro-social factors and the use of psychoactive substances. From this population, 2 groups were selected, parents who were abusive and parents who were not abusive towards their own children. In both groups the frequency of different factors that could explain the probability of abusive behaviour of the adults towards their children was evaluated. We analysed the association between aggressive behaviour against one's own children and having a history of child abuse. As a measure of association, the OR was used with its respective 95% confidence interval and P-value<.05. Results: 187 adults were included, 63.1% were women. The median [IQR] age was 38 [2452] years. The abusive behaviour of the parents towards their children was associated with: the female sex (OR = 2.23; 95%CI, 1.13-4.40), partner's aggression (OR = 3.28; 95%CI, 1.58-6.80), aggression towards other people outside the family (OR = 2.66; 95%CI, 1.05-6.74), pro-social behaviour (OR = 0.32; 95%CI, 0.14-0.73), and dysfunctional behavioural traits (OR = 2.23; 95%CI, 1.11-4.52). There was no association with the history of child abuse (OR= 1.54; 95%CI, 0.59-4.04). Conclusions: The history of abuse in the parents' childhood was not associated with abusive behaviour towards their children. Other forms of partner's violence and non-family violence were associated, suggesting that child abuse in the study population was related to other expressions of family and social violence.

17.
Rev. colomb. psiquiatr ; 48(1): 26-34, ene.-mar. 2019. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1013957

RESUMEN

ABSTRACT Introduction: Perinatal stress and the impact generated by adverse conditions could affect fetal development negatively with long term and short term manifestations and could increase the risk of maternal depression. Objective: To determine the psychosocial risk factors present in women with high-obstetric risk and hospitalized in a high complexity institution. Methods: A cross-sectional study that included 112 pregnant or immediate postpartum women, who were evaluated using a scale designed by the researchers and the Edinburgh Postnatal Depression Scale. Results: Median age was 24 (RIC 9) years; 39.3% of the women were pregnant, and 65.9% had a gestational age of more than 28 weeks. The main reason for hospitalization was threat of preterm delivery in 39.2%. 52.4% planned the pregnancy and 22.3% had depressive symptoms compatible with depression. Suicidal ideas and suicide attempts were more prevalent in the first trimester (7.2% and 3.6%). Discussion: The high prevalence of depressive symptoms in the population studied coincides with what was reported in similar studies in Latin America. The fact that pregnancy does not protect against suicide was confirmed. Conclusions: Psychosocial screening is recommended in every pregnant woman and women in immediate postpartum to detect symptoms and risk factors for depression.


RESUMEN Introducción: El estrés perinatal y el impacto generado por condiciones adversas, podrían afectar negativamente el desarrollo fetal con manifestaciones a corto y largo plazo, y aumentaría el riesgo de desarrollar depresión materna. Objetivo: Determinar los factores de riesgo psicosocial presentes en mujeres con alto riesgo obstétrico hospitalizadas en una institución de alta complejidad. Metodología: Estudio transversal que incluyó 112 mujeres embarazadas o en posparto inmediato, evaluadas a través de una escala diseñada por las investigadoras y la Escala de Depresión Posparto de Edimburgo. Resultados: La mediana para la edad fue 24 anos (RIC 9). El 39,3% de las mujeres estaban embarazadas. El 65,9% tenía una edad gestacional mayor de 28 semanas. El principal motivo de hospitalización fue la amenaza de aborto en el 39,2%. El 52,4% planeó el embarazo y 22,3% tenía síntomas depresivos compatibles con depresión. Las ideas e intentos suicidas, fueron más prevalentes en el primer trimestre (7,2% y 3,6%). Discusión: Las características sociodemográficas y clínicas de la población estudiada coinciden con lo reportado previamente. La alta prevalencia de síntomas depresivos en la población estudiada coincide con lo reportado en estudios similares en Latinoamérica. Se confirma que el embarazo no protege contra el suicidio. Conclusiones: Se recomienda incluir tamización psicosocial a toda mujer en embarazo y post parto inmediato para detectar síntomas y factores de riesgo susceptibles de ser intervenidos precozmente y evitar desenlaces negativos tanto para la madre como para el neonato.

18.
Rev Colomb Psiquiatr ; 48(1): 17-25, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30651168

RESUMEN

INTRODUCTION: One of the experiences that represent the biggest risk for any society is child abuse. Despite the consequences of this form of violence, it tends to be a hidden and little understood phenomenon. The reason why parents mistreat their children has been one of the issues that has raised the most interest in the investigation of this phenomenon. OBJECTIVE: To determine how the history of child abuse in adults is related to abusive behaviour directed at their own children. METHODOLOGY: A cross-sectional study, based on a source of secondary information. The study included sociodemographic variables, variables related to violent behaviours directed to other people, pro-social factors and the use of psychoactive substances. From this population, 2 groups were selected, parents who were abusive and parents who were not abusive towards their own children. In both groups the frequency of different factors that could explain the probability of abusive behaviour of the adults towards their children was evaluated. We analysed the association between aggressive behaviour against one's own children and having a history of child abuse. As a measure of association, the OR was used with its respective 95% confidence interval and P-value<.05. RESULTS: 187 adults were included, 63.1% were women. The median [IQR] age was 38 [24-52] years. The abusive behaviour of the parents towards their children was associated with: the female sex (OR=2.23; 95%CI, 1.13-4.40), partner's aggression (OR=3.28; 95%CI, 1.58-6.80), aggression towards other people outside the family (OR=2.66; 95%CI, 1.05-6.74), pro-social behaviour (OR=0.32; 95%CI, 0.14-0.73), and dysfunctional behavioural traits (OR=2.23; 95%CI, 1.11-4.52). There was no association with the history of child abuse (OR=1.54; 95%CI, 0.59-4.04). CONCLUSIONS: The history of abuse in the parents' childhood was not associated with abusive behaviour towards their children. Other forms of partner's violence and non-family violence were associated, suggesting that child abuse in the study population was related to other expressions of family and social violence.


Asunto(s)
Agresión/psicología , Maltrato a los Niños/estadística & datos numéricos , Relaciones Padres-Hijo , Violencia/estadística & datos numéricos , Adulto , Niño , Maltrato a los Niños/psicología , Colombia/epidemiología , Estudios Transversales , Violencia Doméstica/psicología , Violencia Doméstica/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales , Conducta Social , Violencia/psicología , Adulto Joven
19.
Rev Colomb Psiquiatr ; 48(1): 26-34, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30651170

RESUMEN

INTRODUCTION: Perinatal stress and the impact generated by adverse conditions could affect fetal development negatively with long term and short term manifestations and could increase the risk of maternal depression. OBJECTIVE: To determine the psychosocial risk factors present in women with high-obstetric risk and hospitalized in a high complexity institution. METHODS: A cross-sectional study that included 112 pregnant or immediate postpartum women, who were evaluated using a scale designed by the researchers and the Edinburgh Postnatal Depression Scale. RESULTS: Median age was 24 (RIC 9) years; 39.3% of the women were pregnant, and 65.9% had a gestational age of more than 28 weeks. The main reason for hospitalization was threat of preterm delivery in 39.2%. 52.4% planned the pregnancy and 22.3% had depressive symptoms compatible with depression. Suicidal ideas and suicide attempts were more prevalent in the first trimester (7.2% and 3.6%). DISCUSSION: The high prevalence of depressive symptoms in the population studied coincides with what was reported in similar studies in Latin America. The fact that pregnancy does not protect against suicide was confirmed. CONCLUSIONS: Psychosocial screening is recommended in every pregnant woman and women in immediate postpartum to detect symptoms and risk factors for depression.


Asunto(s)
Depresión Posparto/epidemiología , Complicaciones del Embarazo/epidemiología , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos , Adolescente , Adulto , Colombia/epidemiología , Estudios Transversales , Depresión Posparto/diagnóstico , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Tamizaje Masivo/métodos , Persona de Mediana Edad , Embarazo , Complicaciones del Embarazo/psicología , Nacimiento Prematuro/epidemiología , Prevalencia , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Adulto Joven
20.
Rev. Fac. Nac. Salud Pública ; 36(3): 109-119, sep.-dic. 2018. tab
Artículo en Español | LILACS-Express | LILACS | ID: biblio-985118

RESUMEN

Resumen Objetivo: Validar, en un contexto colombiano, el contenido de la primera cartilla del programa "Niñ@s en Movimiento" (diseñada en España), dirigida a padres o cuidadores, y a los niños que padecen sobrepeso u obesidad, disponible en internet con acceso libre. Metodología: Investigación cualitativa. Tras el proceso de selección, participaron 14 niños con sobrepeso y sus padres o cuidadores, del Colegio Básico "Camino de Paz" de Medellín. Para la clasificación de los datos antropométricos se utilizó el programa de la Organización Mundial de la Salud. Para la validación de la cartilla se elaboró una guía de preguntas y se realizaron grupos focales; se usaron los criterios de atractividad, entendimiento, identificación, aceptación e inducción a la acción. Los datos se analizaron mediante el software spss® versión 21.0, y un protocolo de análisis de datos. Resultados: En la sección "La importancia del desayuno", del material educativo, algunos padres o cuidadores manifestaron que es necesario indicar la forma adecuada para preparar los alimentos, en qué condiciones y qué cantidad deben servirles a sus hijos, lo cual no es claro en la cartilla. Respecto a los niños, en las secciones "Mis desayunos" y "Clasificación de los alimentos" se encontró que las palabras técnicas dificultan la comprensión; además, al hablar de la clasificación de alimentos, algunos no los han visto ni consumido. En la evaluación de los criterios por parte del padre o cuidador, el entendimiento fue mal calificado, porque no son claros algunos términos; los niños también calificaron negativamente este criterio, por la dificultad para entender vocabulario desconocido debido a su contexto extranjero. Conclusiones: El desayuno, aunque es un hábito establecido, puede mejorar; sin embargo, las orientaciones de la cartilla tendrían que adaptarse al lenguaje y a la cultura alimentaria local, para que las recomendaciones mejoren la aplicabilidad de este recurso educativo.


Abstract Objective: To validate the content of the first booklet "Niñ@s en Movimiento" (designed in Spain), in the Colombian setting, targeting parents or caretakers, and overweight or obese chil dren, which is available free online. Methodology: Qualitati ve research. After a selection process, 14 overweight children and their parents or caretakers were selected to participate. The children were students at the Colegio Básico "Camino de Paz" School in Medellin. To classify anthropometric data, the study used the World Health Organization program. To validate the booklet, a question guideline was drawn up and focus groups were held. The criteria used included attraction, comprehen sion, identification, acceptance and induction to action. Data were analyzed using the SPSS® software Version 21.0, and a data analysis protocol. Results: In the section "the impor tance of breakfast", in the educational material, some parents or caretakers stated that it is necessary to indicate an adequa te way to prepare food, how to serve it and the amounts that they should their children, which is not clear in the booklet. Regarding the children, in the sections "my breakfasts" and "food classification", there were technical words that compli cated comprehension. Furthermore, when talking about food classification, there are foods they have not seen nor eaten. In the parent or caretaker criteria evaluation, comprehension was poorly scored, as some of the terms were not clear. The children also ranked negatively this criterion. Vocabulary was difficult to understand because it had a foreign context. Con clusions: Breakfast, although an established habit, can impro ve; nevertheless, the guidelines of the booklet would have to be adapted to local language and food culture so that these recommendations may improve the applicability of this edu cational resource.


Resumo Objetivo: Avaliar, num âmbito colombiano, o conteúdo da primeira apostilha do programa "Menin@s em Movimento" (desenhada na Espanha), voltada aos pães ou cuidadores, e aos meninos que padecem sobrepeso ou obesidade, disponível na internet com ingresso libre. Metodologia: Investigação qua litativa. Trás o processo de escolha, participaram 14 meninos com sobrepeso e os seus pães ou cuidadores, da Escola Básica "Caminho de Paz" do Medellín. Para a classificação dos da dos antropométricos se utilizou o programa da Organização Mundial da Saúde. Para a avaliação da apostilha se elaborou uma guia de perguntas e se realizaram grupos focais; se usaram os critérios de atratividade, entendimento, identificação, acei tação e indução pra ação. Os dados se analisaram mediante o software SPSS® versão 21.0, e um protocolo de análises de dados. Resultantes: Na seção "A importância do dejejum", do material educativo, alguns pães ou cuidadores manifestaram que é quesito indicar o jeito mais pertinente na preparação dos alimentos, em que condições e qual quantidade devem servir-lhes aos seus filhos, o qual não apresenta clareza na cartilha. Aludindo aos meninos, nas secções "Meus cafés da manhã" e "Classificação dos alimentos" se encontrou que as expressões técnicas dificultam a compreensão; além disso, ao mencionar a classificação dos alimentos, alguns nem os conhecem nem consumiram jamais. Na avaliação dos critérios por parte do pai ou cuidador, ou entendimento foi mal qualificado, porque não são simples alguns termos; os meninos também qualificaram negativamente este critério, pela dificuldade para compreender glossário desconhecido devido ao seu contexto estrangeiro. Conclusões: O dejejum, ainda que é um hábito estabelecido, pode melhorar; contudo, as dicas do caderno teriam que se customizar com a linguajem e as tradições alimentares locais, para que as recomendações melhorem a aplicabilidade de este recurso educativo.

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