Relación entre sobrecompromiso y síntomas somáticos en enfermeras de un hospital de II nivel en Perú

Objetivo : Determinar la relación entre sobrecompromiso y síntomas somáticos en enfermeras de un hospital de II nivel en Perú. Material y métodos : Investigación observacional, transversal y correlacional, con una muestra probabilística de 106 enfermeras. Se aplicó el Cuestionario de Siegrist y Meter para medir sobrecompromiso y desequilibrio esfuerzo recompensa, y el Cuestionario de Salud (PHQ15) para síntomas somáticos. Se construyó un modelo de regresión logística, considerando variables sociodemográficas y laborales. Resultados : En las enfermeras que presentaron síntomas somáticos moderados-graves, el 68,3% tuvo un nivel de sobrecompromiso alto. El modelo de regresión mostró que sobrecompromiso (OR = 6,25, p < 0,01), tiempo laboral (OR = 0,74, p < 0,01) y la condición de personal (nombrado o contratado, OR = 49,20, p < 0,01) influyeron en el nivel de síntomas somáticos. El modelo discriminó correctamente el 79% (IC 95%: 0,70 - 0,88) de los casos con síntomas somáticos, siendo el valor 0,43, el que se usò para la clasificaciòn en leve-mìnimo y moderado-grave con una sensibilidad de 73% y especificidad del 74%. Conclusión : Se corroboró una relación significativa entre sobrecompromiso y síntomas somáticos, con un modelo predictivo que logró un nivel elevado de discriminación para identificar personal de enfermería en riesgo.

SUMMARY Objective : To determine the relationship between over commitment and somatic symptoms among nurses in a type II hospital in Peru. Methods : A cross-sectional study with a probabilistic sample of 106 participants was carried-out. The Siegrist and Meter questionnaire was applied to measure over commitment and imbalance effort-recompense and the Health Questionnaire (PHQ15) was applied to evaluate somatic symptoms. A logistic regression model was built considering sociodemographic and labor variables. Results : The 68.3% of nurses that presented with moderate to severe somatic symptoms had a high level of over commitment. The regression model showed that over commitment (OR = 6.25, p < 0.01), time in the working place (OR = 0.74, p < 0.01) and labor status (staff or hired temporarily OR = 49.20, p < 0.01) influenced the level of somatic symptoms. The model discriminated well the 79% (95% CI: 95%: 0.70 - 0.88) of somatic cases. A value of 0.43 was selected to discriminate between mild to moderate-severe with a sensitivity of 73% and 74% specificity. Conclusions : A signifcant correlation between over commitment and somatic symptoms ws found. The regression model attained a high discriminative level to identify nurses at risk.

Mental Health in COVID-2019 Survivors from a General Hospital in Peru: Sociodemographic, Clinical, and Inflammatory Variable Associations.

The current coronavirus disease-2019 (COVID-19) pandemic constitutes a significant public health problem worldwide, as well as mental health problems. This study aimed to evaluate the mental health of COVID-19 survivors, considering their sociodemographic, clinical, and immune variables. A cross-sectional and correlational study was conducted on 318 COVID-19 survivors from one hospital in Peru. Through telephone interviews, evaluation of the presence of depressive symptoms using the Patient Health Questionnaire-9, anxiety symptoms through the Generalized Anxiety Disorder-7, somatic symptoms through Patient Health Questionnaire-15, and posttraumatic stress disorder (PTSD) symptoms through Impact of Event Scale-Revised was carried out. Poisson regression analyses were performed with their adjusted variances to calculate the prevalence ratio (PR) with their 95% confidence interval. All regression models were adjusted (PRa) for follow-up time. A significant proportion of patients have depressive (30.9%), anxious (31.1%), somatic (35.2%), and PTSD (29.5%) symptoms. The variables associated with a higher frequency of clinically relevant mental symptoms were female sex, self-perception of greater COVID-19 severity, presence of persistent COVID-19 symptoms, loss of a family member due to COVID-19, and prior psychiatric diagnosis or treatment. In addition, the neutrophil-to-lymphocyte ratio was significantly higher in patients with clinically relevant symptoms of depression. COVID-19 survivors showed a high prevalence of negative mental symptoms. Our findings help to identify patients who are vulnerable and require psychiatric care.

Association between attention performance and the different dimensions of DSM-5 depression symptoms.

Objective: Depressive symptoms can be assessed with self-reported questionnaires, such as the Patient Health Questionary-9 (PHQ-9). Previous studies have suggested that the PHQ-9 items can be grouped into somatic and non-somatic clusters. However, the classification of the PHQ-9 item "concentration difficulties" into somatic or non-somatic is still controversial. This controversy may be explained by difficulties experienced by subjects in accurately evaluating their attention problems. The primary objective of this study was to determine the correlation between objective attentional performance and the two clusters of depressive symptoms in hospital employees working in stressful conditions. Methods: The participants filled out the PHQ-9 to identify their depressive symptoms. Based on the PHQ-9, the somatic or non-somatic symptoms were measured without considering the question about subjective concentration difficulties. Then, a brief version of the Continuous Visual Attention Test (CVAT) was applied to assess four attentional subdomains. The CVAT is a Go/No-go task that measures number of correct responses (focused attention), number of incorrect responses (behavior-inhibition), average reaction time of correct responses (RT-alertness), and variability of reaction time (VRT-sustained attention). The entire task lasted 90 s. Correlation analyses assessed the relationships between attentional performance and the two dimensions of depressive symptoms. Results: After applying the inclusion/exclusion criteria, 359 individuals were selected. Their age ranged from 20 to 70 years (mean = 40.5, SD = 10.37), and the majority was female (67.6%). A predominance in somatic depressive symptoms was present in 231 (64%) participants, whereas 59 (16%) showed a predominance of non-somatic symptoms. Sixty-nine participants (20%) did not show any predominance. Higher somatic scores were associated with higher RTs, whereas higher non-somatic scores were related to an increase in the number of incorrect responses. Conclusion: The predominance of the somatic cluster was related to lower alertness, whereas the predominance of non-somatic cluster was associated with impulsivity/hyperactivity. This result may explain the difficulties associated with correctly classifying the item concentration difficulties. A brief attentional task can be used as an auxiliary tool to correctly identify the different dimensions of attention that are associated with different clusters of depressive symptoms.

Translation, cultural adaptation and validation of the Somatic Symptom Scale-8 (SSS-8) for the Brazilian Portuguese language.

BACKGROUND: Assessment tools are commonly used in different fields of health to assist in the diagnosis, the evaluation of the response to treatment, the measurement of quality of life and the establishment of the prognosis. OBJECTIVES: Translate, culturally adapt and perform the psychometric validation of the Somatic Symptom Scale (SSS-8) for use in the Brazilian population. METHODS: Cross-cultural adaptation followed a combination of guidelines and for psychometric evaluation a sample of 300 patients was recruited. All recommended measurement properties by the Consensus-based Standards for the selection of health status Measurement Instruments were evaluated, including analysis by an expert committee and analysis by the target public. The Skindex-16 was used for the evaluation of convergent validity and Cronbach's alpha was used for the determination of the internal consistency of the translated version of the SSS-8. RESULTS: The final version received approval from five experts and the agreement index was 100% for all items. During the pretest, the scale was administered to 300 patients with psoriasis and none of the items needed to be altered. A moderate correlation was found between the Skindex-16 and SSS-8-BRA. In the analysis of internal consistency, Cronbach's alpha for the SSS-8-BRA was 0.81. CONCLUSION: The SSS-8 is a valid and reliable tool for the assessment of somatic symptoms in the Brazilian population.

Los trastornos psicosomáticos en el niño y el adolescente / The psychosomatic disorders in children and adolescents

Los trastornos psicosomáticos se caracterizan por manifestaciones somáticas de origen no patológico y poseen una significativa prevalencia en niños y adolescentes; sin embargo, resulta difícil identificarlos, pues no existe un consenso adecuado para su diagnóstico y las investigaciones acerca del tema son insuficientes. Lo anterior condujo a efectuar el presente artículo, en el que se abordan aspectos etiopatogénicos y clinicoepidemiológicos que proporcionan los principales elementos para identificar dichos trastornos y establecer un diagnóstico acertado; asimismo se destaca que estas afecciones son frecuentes en poblaciones infantojuveniles con rasgos de introversión y/o antecedentes personales y familiares de enfermedades físicas y mentales, y que su causa es multifactorial, aunque entre los muchos factores sobresalen la vulnerabilidad al estrés, la disfunción familiar, la sobreprotección parental, así como también las situaciones precipitantes (acoso escolar, separación de los padres, abuso sexual) y las perpetuadoras; estas últimas están condicionadas por los beneficios primario y secundario que los menores obtienen de estos padecimientos.

The psychosomatic disorders are characterized by somatic signs of non-pathological origin which possess a significant prevalence in children and adolescents; however, it is difficult to identify them, because there is no appropriate consent for its diagnosis and the investigations about the topic are insufficient. That is the reason why we decided to carry out the present work, in which some etiopathogenic, clinical and epidemiological aspects are approached that provide the main elements to identify these disorders and to establish a good diagnosis; it is also relevant that these disorders are frequent in juvenile populations with introversion features and/or personal and family history of physical and mental diseases, with multifactorial cause, although among the many relevant factors we can mention vulnerability to stress, family dysfunction, parental overprotection, as well as the precipitant situations (school harassment, parents' separation, sexual abuse) and the permanent situations; the latter are conditioned by the primary and secondary benefits that minors obtain with these sufferings.

Emotional Exhaustion in Housewives and Alzheimer Patients' Caregivers: Its Effects on Chronic Diseases, Somatic Symptoms and Social Dysfunction.

BACKGROUND: Emotional exhaustion causes adverse effects in those who suffer from it. Housewives are not excluded. Domestic and care chores, which are considered to be sources of stress, increase when taking on the role of caregiver for a family member with Alzheimer's disease. OBJECTIVE: To analyse the influence of emotional exhaustion, somatic symptoms and social dysfunction, based on the activity they carry out. METHODOLOGY: Cross-sectional survey. 193 women participated, of which: housewives (HWs) (n = 97), and Alzheimer's patient caregiver-housewives (CHWs) (n = 96). The evaluation tools were: sociodemographic/working data questionnaire (ad hoc), Maslach Burnout Inventory (MBI) and Goldberg General Health Questionnaire (GHQ-28). RESULTS: High rates of emotional exhaustion are observed, as well as an existing positive link between chronic diseases, somatic symptoms and social dysfunction. The structural model indicates that emotional exhaustion predicts the amount and extent of diseases, somatic symptoms and social dysfunction. The influence is higher in CHWs. LIMITATIONS: Sample procedure implemented at convenience; the variable of the grade of dependence of the Alzheimer's patient caregiver was not included in the study. CONCLUSIONS: The domestic and care chores that HWs and CHWs carry out affect their health. Hence the need to develop psychoeducative programmes that are adapted to the particular needs of these women and focused on the different areas of their everyday lives.

Depressão materna e ajustamento conjugal de mães jovens e sua relação com a sintomatologia psicofuncional do bebê / Maternal depression and marital adjustment of young mothers and its relationship with baby's psychofunctional symptoms

Este estudo investigou a depressão materna e a percepção de ajustamento conjugal de mães jovens, para compreender a sua repercussão sobre a sintomatologia psicofuncional do bebê. Trata-se de estudo de casos contrastantes, transversal, no qual foram entrevistadas duas mães (20 a 21 anos) porto-alegrenses, cujos bebês tinham 8 e 11 meses. Foram aplicados também o R-DAS, a EPDS e o Symptom Check List, para avaliar, respectivamente, ajustamento conjugal, depressão materna e sintomas psicofuncionais do bebê. Os dados foram integrados na análise dos casos. Os resultados apontam que a percepção de ajustamento conjugal ruim e a presença de depressão materna podem repercutir sobre a sintomatologia psicofuncional do bebê, por meio de um processo de spillover, isto é, transbordamento dos desajustes conjugais sobre a relação parental. Esses achados são relevantes para a prática clínica, na busca de intervenções psicológicas que promovam a saúde mental de casais e bebês.(AU)

This study investigated maternal depression and perception of marital adjustment of young mothers, to understand its impact on the baby's psychofunctional symptoms. It is a transversal contrasting cases study, in which two mothers (20 and 21years), whose babies were 8 and 11 months old, from Porto Alegre/RS, were interviewed. R-DAS, EPDS and Symptom Check List were also applied to evaluate, respectively, marital adjustment, maternal depression and baby's psychofunctional symptoms. Data were integrated in the case analysis. The results suggest that perception of poor marital adjustment and presence of maternal depression may contribute to baby's psychofunctional symptoms, through a spillover process, i.e., the overflow of marital maladjustment on parental relationship. These findings are relevant to clinical practice, in searching for psychological interventions that promote the mental health of couples and babies.(AU)

Avaliação de sintomas psicofuncionais em bebês: revisão crítica da literatura sobre o uso do symptom checklist / Evaluation of psychofunctional symptoms in infants: a critical review of the literature on the use of the symptom checklist / Evaluación de síntomas psicofuncionales en los bebés: revisión crítica de la literatura sobre el uso de symptom checklist

Esse trabalho objetivou apresentar os estudos que utilizaram o Symptom Checklist (SCL) para avaliar sintomas psicofuncionais em bebês. Foram detalhados os países em que os trabalhos foram realizados, o delineamento dos estudos e as principais variáveis associadas. Para tanto, foi realizada uma revisão crítica da literatura, considerando trabalhos que utilizaram o SCL. Identificou-se que a prevalência de sintomas psicofuncionais em bebês ainda é um dado desconhecido tanto no Brasil quanto no exterior, ainda que exista um predomínio de estudos europeus. Embora o SCL possa ser usado em pesquisas com diversos tipos de delineamentos, destacaramse estudos longitudinais. Os achados também permitiram problematizar as propriedades psicométricas do instrumento. Sugere-se a realização de novos estudos, bem como uma ampliação no uso e na divulgação do SCL, uma vez que o instrumento permite uma avaliação compreensiva e detalhada da saúde e do desenvolvimento infantil.

This study aimed to present the studies that used the Symptom Checklist (SCL) to evaluate psychofunctional symptoms infants. Were detailed the countries that the studies were carried out, the design of the articles and the main variables associated. Therefore, a critical review of the literature was performed, considering works that used the SCL instrument. It was found that the prevalence of symptoms of infants, is still unknown in Brazil and abroad, although there is a predominance of studies in the European context. Although the SCL can be used in various types of research designs, longitudinal studies were predominant. The findings also allowed to question the psychometric properties of the instrument. It is suggested to carry out new studies, as well as an expansion in the use and divulgation of SCL, since the instrument allows a comprehensive and detailed assessment of health and child development.

Esta investigación tuvo como objetivo presentar los estudios que utilizaron el Symptom Checklist (SCL) para evaluar los síntomas psicofuncionales en bebés. Fueron detallados los países en los que el trabajo se lleva a cabo, el diseño de los estudios y las principales variables asociada. Por lo tanto, se realizó una revisión crítica de la literatura, teniendo en cuenta los estudios que utilizaron el SCL. Se encontró que la prevalencia de síntomas en los bebés psicofuncionales sigue siendo una incógnita tanto en Brasil como en el extranjero, aunque hay un predominio de los estudios europeos. Aunque el SCL se puede utilizar en la investigación de varios tipos de diseños, se destacaron estudios longitudinales. Los resultados también permiten a cuestionar las propiedades psicométricas del instrumento. Se sugiere conducir nuevos estudios, así como una expansión en el uso y divulgación de SCL, ya que el instrumento permite una evaluación completa y detallada de salud y desarrollo infantil

Relevancia de la menopausia y del apoyo social en las diferencias en salud entre mujeres y hombres / Relevance of the Menopause and Social Support in Gender Differences in Health

RESUMEN Se analizó la relevancia de la menopausia y el apoyo social en las diferencias en salud entre mujeres y hombres mediante un estudio transversal realizado con 710 mujeres y 606 hombres de la población general española con edades entre 20 y 65 años. Se encontró que, aunque en la juventud apenas había diferencias entre hombres y mujeres, a partir de la perimenopausia las mujeres informaban de más insomnio y síntomas vasomotores que los hombres, así como de más dolor durante la postmenopausia. El apoyo social percibido se asociaba con mejor salud, sobre todo en las mujeres en postmenopausia y premenopausia.

ABSTRACT This study examined the relevance of the menopause and social support in gender differences in health. A cross-sectional survey of a general population sample comprising 710 women and 606 men, aged between 20 and 65 was carried out. No health differences were found between younger men and women. However, perimenopausal women reported more insomnia and vasomotor symptoms, as well as they reported more pain than men through the postmenopause. Perceived social support was associated with better health, especially in premenopausal and postmenopausal women.

Síntomas somáticos en preadolescentes de 10 a 12 años con sobrepeso u obesidad / Somatic symptoms in preadolescents aged 10-12 years with overweight or obesity

Resumen: INTRODUCCIÓN: Numerosos estudios han relacionado la obesidad y el sobrepeso con síntomas físicos, psicológicos y sociales, pero son escasos los trabajos que examinan la presencia de síntomas somáticos en niños con exceso de peso. OBJETIVO: Conocer si existen diferencias en la manifestación de síntomas somáticos en preadolescentes de 10 a 12 años en función de su categoría ponderal (normopeso y sobrepeso/obesidad), así como en otras variables relacionadas con la enfermedad (veces en el último mes que han estado enfermos, que han acudido al médico o que han faltado a clase por estar enfermos y existencia de enfermedades en los miembros de su familia). MÉTODO: Se trata de un estudio transversal de casos y controles en el que participaron 668 preadolescentes, de los que 301 presentaban normopeso y 367 exceso de peso (obesidad o sobrepeso). Los participantes completaron el Children's Somatization Inventory que examina la presencia de síntomas gastrointestinales, pseudoneurológicos y dolor. Para el análisis de los datos se llevó a cabo un análisis multivariado de la varianza. RESULTADOS: No se hallaron diferencias significativas en función de la categoría ponderal en la manifestación de síntomas somáticos. Las diferencias fueron significativas únicamente en función del sexo, presentando las niñas más síntomas gastrointestinales que los niños (F [1,666] = 8.71; p = .003). Al examinar la sintomatología en cada subgrupo, se hallaron diferencias entre los niños con normopeso y obesidad/sobrepeso, mostrando estos últimos más falta de energía o cansancio (χ2 = 5.35; p < .05), dificultad para respirar (χ2 = 7.51; p < .01), convulsiones (χ2 = 4.12; p < .05) y mala digestión (χ2 = 4.89; p < .05). Además, fue mayor el porcentaje de niños con normopeso que no tiene ningún familiar enfermo respecto a los que presentaron obesidad o sobrepeso (χ2 = 2.47; p < .01). DISCUSIÓN Y CONCLUSIÓN: En su conjunto, los resultados confirman la necesidad de valorar de forma exhaustiva y multidisciplinar la sintomatología física y psicológica de los niños y niñas obesos y con sobrepeso, para poder ofrecer una intervención exitosa, no sólo centrada en la reducción de peso, sino en la mejora de su calidad de vida.

Abstract: INTRODUCTION: Numerous studies have linked obesity and overweight with physical, psychological and social symptoms, but few of them have examined the presence of somatic symptoms in children or adolescents with obesity or overweight. OBJECTIVE: To examine somatic symptoms in preadolescents from 10 to 12 years old depending on their weight category (normal weight and overweight/obesity), as well as other variables related to the disease (times that preadolescents had been sick, had gone to the doctor or had been absent to class for having a disease in the last month, and existence of diseases in the members of their family). METHOD: A cross-sectional study was carried out with 668 pre-adolescents; 301 of them showed normal weight and 367 showed overweight or obesity. They completed the Children's Somatization Inventory that examines gastrointestinal symptoms, pseudoneurological symptoms, and pain. A multivariate analysis of the variance was performed to analyse the data. RESULTS: No significant differences in gastrointestinal symptoms, pseudoneurological symptoms and pain in function of the weight category were found. Differences were only significant in function of gender, showing girls more gastrointestinal symptoms than boys (F [1,666] = 8.71; p = .003). When examining each somatic symptom, differences were found depending on the weight category, showing participants with overweight or obesity more fatigue (χ2 = 5.35; p < .05), breathing problems (χ2 = 7.51; p < .01), seizures (χ2 = 4.12; p < .05), and poor digestion (χ2 = 4.89; p < .05). The percentage of participants with overweight or obesity who had a sick relative was higher comparing to those with normal weight (χ2 = 2.47; p < .01). DISCUSSION AND CONCLUSION: Overall, the results highlight the importance of examining physical and psychological symptoms in pre-adolescents with overweight or obesity to develop a successful intervention focused not only on the weight reduction but also in the improvement of their quality of life.

Race/ethnicity moderates the relationship between depressive symptom severity and C-reactive protein: 2005-2010 NHANES data.

Because few studies have examined depression facets or potential moderators of the depression-inflammation relationship, our aims were to determine whether particular depressive symptom clusters are more strongly associated with C-reactive protein (CRP) levels and whether race/ethnicity moderates these relationships. We examined data from 10,149 adults representative of the U.S. population (4858 non-Hispanic White, 1978 non-Hispanic Black, 2260 Mexican American, 1053 Other Hispanic) who participated in the cross-sectional National Health and Nutrition Examination Survey between 2005 and 2010. Depressive symptoms were assessed by the Patient Health Questionnaire-9, and high-sensitivity serum CRP was quantified by latex-enhanced nephelometry. Total (p<.001), somatic (p<.001), and nonsomatic (p=.001) depressive symptoms were each positively related to serum CRP in individual models. However, in the simultaneous model that included both symptom clusters, somatic symptoms (p<.001), but not nonsomatic symptoms (p=.98), remained associated with serum CRP. Evidence of moderation by race/ethnicity was also observed, as six of the nine depressive symptoms×race/ethnicity interactions were significant (ps<.05). Among non-Hispanic Whites, the pattern of results was identical to the full sample; only somatic symptoms (p<.001) remained related to serum CRP in the simultaneous model. No relationships between total, somatic, or nonsomatic symptoms and serum CRP were observed among the non-Hispanic Black, Mexican American, or Other Hispanic groups. Our findings indicate that the link between depressive symptoms and systemic inflammation may be due to the somatic symptoms of sleep disturbance, fatigue, appetite changes, and psychomotor retardation/agitation and may be strongest among non-Hispanic Whites.

Roles sexuales y salud mental en una muestra de la población general española / Sex roles and mental health in a sample of the general Spanish population

Research on gender differences in health has generally shown that women report higher levels of minor psychiatric morbidity than men. One of the explicative variables for these findings is the different social roles of women and men. Sex role ideology refers to beliefs about appropriate roles for each gender, and is relevant from a psychological point of view because it is associated with self-definition, interactions between men and women and social relations. Most societies consider that women and men are different and consider that they should adopt different roles. These roles determine different social behaviors. Masculinity and femininity refer to feature differences, behaviours and interests assigned by society to each gender. The other two gender role categories proposed by Sandra Bem are androgyny (characterized by the presence of feminine and masculine characteristics) and an undifferentiated sex role (referring to individuals who have low levels of masculine or feminine characteristics). Classic theories on sex typing and gender role differences between women and men have suggested that such differences have been considered as normal and healthy, since they reflect social norms regarding appropriate behaviour in women and men. Furthermore, there is a tendency within mental health professionals who view masculine men and feminine women as normal and healthy. Nevertheless, research on this matter has not provided empirical evidence in relation to such hypotheses. It has also been suggested that reversing gender ideals can be stressful for men and women because such ideals are socially imposed, and therefore, obstruct self-regulation and are connected to the external representation of self-value. The aim of the current study is to find out whether there are mental health differences in a sample of the general Spanish population among the categories of sex role proposed by Sandra Bem. These categories are: masculine, which refers to individuals with high scores in masculinity and low scores in femininity; feminine, which comprises those individuals with high scores in femininity and low scores in masculinity; androgynous, which includes individuals with high scores in masculinity and femininity; and undifferentiated, which gathers those individuals with low scores in masculinity and femininity. The sample included 197 women and 140 men from the general population who voluntarily took part in the study. Participants ranged in age from 17 to 74 years, with a mean of 32.2 years (SD = 12.2), and with different social and demographic characteristics. They were assessed using the Bem Sex Role Inventory (BSRI), the Goldberg General Health Questionnaire (GHQ-28) and the Self-Esteem Inventory (SEQ). In order to know whether there were any statistically significant differences in health according to sex roles, and whether these interacted with gender, analysis of variance(ANOVA)and multivariate analysis of variance (MANOVA) were performed. The factors in all of them were the four sex role categories (androgynous, masculine, feminine and undifferentiated) and gender (men, women); and the dependent variables were the scores in GHQ-28 in the first group of analysis, and the two self-esteem factors in the second. In the MANOVA where the dependent variables were the four GHQ-28 scales of symptoms, we found that the interaction between sex roles and gender was statistically significant. When performing the analysis independently for each gender, we found that in the male sample there were statistically significant differences only according to sex roles in somatic symptoms. Men with undifferentiated sex roles showed fewer somatic symptoms than men with feminine or androgynous sex roles. In the female sample, we found statistically significant differences according to sex roles in somatic, anxiety and insomnia symptoms. Post hoc analysis with the Bonferroni adjustment showed that statistically significant differences occurred between the female groups with undifferentiated and androgynous sex roles. The latter female group showed fewer somatic, anxiety and insomnia symptoms. The analysis of the differences between women and men in mental health symptoms showed statistically significant differences in somatic, anxiety and insomnia symptoms. Women obtained higher average scores than men. However, there were no statistically significant differences in depressive symptoms nor social dysfunction. When the two factors from the self-esteem questionnaire were considered as dependent variables, the analyses of variance showed that the interaction between sex roles and gender was not statistically significant. Gender main effects were not statistically significant either, however sex role main effects were statistically significant. Post hoc analysis with the Bonferroni adjustment showed that individuals with an undifferentiated sex role evaluated themselves more negatively, and individuals with a masculine sex role evaluated themselves less negatively than those with a feminine sex role. There was no difference in self-confidence between individuals with androgynous sex roles and individuals with a masculine sex role, but both groups showed greater self-confidence than those individuals with feminine or undifferentiated sex roles. The latter group showed less self-confidence than individuals with a feminine sex role. These findings show that sex-typed individuals do not have better mental health or higher self-esteem than androgynous and undifferentiated individuals. Therefore, as in many other studies in other sociocultural settings, our results confirm the lack of empirical evidence for the traditional perspective that masculinity is better for men and femininity is better for women. Our data shows the complexity of relationships between sex roles and health, which depend on gender and on the kind of mental health indicator used. Therefore, while social dysfunction and depressive symptoms seem to be independent from sex role and gender, the effects of sex role on somatic, anxiety and insomnia symptoms were different for women and men. Whereas in the male sample, those with undifferentiated sex roles were the ones showing fewer somatic symptoms, in the women's sample, those with an androgynous sex role were the ones showing less somatic and anxiety and insomnia symptoms compared to those with an undifferentiated sex role. Nevertheless, self-esteem factors showed the highest differences between the various sex role categories. These factors seem to be the same for women and men. For example, we found that individuals with undifferentiated sex roles show higher negative self-worth and lower self-confidence than individuals classified in the other roles. In addition, individuals with a masculine sex role also value themselves less negatively and have higher self-confidence than individuals with a feminine sex role. Lastly, individuals classified in the androgynous sex role have similar self-confidence levels to those with a masculine sex role. The type of mental health symptoms where statistically significant. Differences between women and men are found, these differences were the same as those found in the female sample with regard to sex roles. This seems to indicate the relevance that sex roles have in mental health (in each gender), as some authors have highlighted. However, this study has some limitations to take into account when interpreting the results. Firstly, it is a transversal study, therefore we can talk about association, but not cause-and-effect relations between sex roles and health. Secondly, the sample is not random therefore it is not possible to generalize these results to the population.

Las investigaciones sobre las diferencias de género en salud mental generalmente muestran que los niveles de menor morbilidad psiquiátrica son mayores en las mujeres que en los hombres, siendo una de las variables explicativas de tales diferencias los roles sociales diferenciados en función del sexo. La ideología de los roles sexuales se refiere a las creencias respecto a qué roles son los adecuados para mujeres y hombres. Esto es relevante desde el punto de vista psicológico porque se asocia con la definición de sí-mismo, con las interacciones entre hombres y mujeres y con las relaciones sociales. La mayoría de las sociedades considera que mujeres y hombres son diferentes y deben ocupar roles distintos, por lo que los socializan de forma distinta. Y la masculinidad y la feminidad se refieren a las diferencias en rasgos, conductas e intereses que la sociedad ha asignado a cada uno de los géneros. Las teorías clásicas sobre las diferencias entre mujeres y hombres en roles de género y en tipificación sexual planteaban que tales diferencias eran normales y saludables, ya que reflejaban las normas sociales sobre la conducta apropiada para cada sexo. Además, los profesionales en salud mental tienden a ver a los hombres masculinos y a las mujeres femeninas como normales y sanas. Sin embargo, los resultados de las investigaciones no han aportado evidencia empírica de tales supuestos. Además, recientemente se ha reconocido que la inversión en los ideales de género puede ser estresante para hombres y mujeres porque se trata de ideales impuestos socialmente, dificultan la autorregulación y están relacionados con la representación externa de la autovalía. Pese a ello, la evidencia empírica no es concluyente, habiéndose realizado la mayoría de estudios sobre roles sexuales y salud con muestras anglosajonas, por lo que se desconoce si tal relación se da también en otras culturas. El objetivo del presente trabajo es conocer si existen diferencias en salud mental, en una muestra de la población general española, entre las cuatro opciones de rol sexual propuestas por Sandra Bem: masculinidad, feminidad, androginia e indiferenciación. La muestra estuvo formada por 337 personas de la población general que participaron voluntariamente en el estudio, sus edades oscilaron entre los 17 y 74 años (M = 32.2, SD = 12.2) y presentaron diferentes características sociodemográficas. Las muestras fueron evaluadas con el Bem Sex Role Inventory (BSRI), con el Cuestionario de salud general de Goldberg (GHQ-28) y con el Inventario de autoestima (Self-Esteem Inventory, SEQ). En los resultados encontramos que la asociación entre roles sexuales y salud mental depende del tipo de indicador de salud utilizado. Además, en la sintomatología somática, de ansiedad y de insomnio, también se encontró una relación estrecha con el género. En la muestra de hombres, los clasificados como indiferenciados presentaron menor sintomatología somática respecto a los clasificados como femeninos o como andróginos, mientras que en la muestra de mujeres las clasificadas como indiferenciadas fueron las que tuvieron más síntomas somáticos, de ansiedad e insomnio respecto a las andróginas. El análisis de las diferencias entre mujeres y hombres en sintomatología de salud mental mostró que se daban diferencias estadísticamente significativas en sintomatología somática, de ansiedad e insomnio, teniendo las mujeres puntuaciones medias más altas que los hombres. Sin embargo, no se obtuvieron diferencias estadísticamente significativas en sintomatología depresiva ni en disfunción social. Dichas diferencias coinciden con las obtenidas en la muestra de mujeres al analizar las diferencias en salud mental en función de los roles sexuales. Ello indica la relevancia que los roles sexuales pueden tener en las diferencias de género en salud mental, como han señalado algunos autores. Los resultados de este estudio muestran que el seguimiento de los roles sexuales tradicionales no conllevan a una mejor salud mental. En conclusión, como se ha encontrado en varios estudios realizados en otros entornos socio-culturales nuestros resultados confirman la falta de apoyo empírico para el modelo tradicional en el cual la masculinidad es mejor para los hombres y la feminidad para las mujeres.

Validity of the Beck Depression Inventory in the postpartum period.

Objective. While there is a recommendation to screen for postpartum depression (PPD), there are worries about the validity of instruments other than the Edinburgh Postnatal Depression Scale; little is known about the construct validity of one of the most used screening instruments, the Beck Depression Inventory, in this period. Methods. This study evaluated the validity and reliability of the BDI in a population-based sample of women and their spouses (n=772) in the postpartum. Additionally, we compared factor scores within the couple. Results. Exploratory factor analysis demonstrated a two-factor solution (depressive symptoms and somatic symptoms), accounting for 44.01% of the total variance. Internal consistency was good (Cronbach's α=0.90). Women had higher scores than their partners in both factors (P<0.001), but not a higher proportion of the total score attributable to somatic symptoms. Conclusion. With little factor variance between women and men, and a similar proportion of somatic symptoms, these results should be taken to reinforce the validity of the BDI in the postpartum.

Relación entre nivel de consumo de alcohol, salud mental y síntomas somáticos en un grupo de trabajadores de la industria gastronómica y hotelera de la Ciudad de México

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Abstract: In facilitating the presence of risk behaviors for health, some conditions inherent to the gastronomical and hotel industry may significantly affect the people working in this market. Among them are non-regular working days, temporary employment, law salaries, problems at work, low professional prestige, minimum development opportunities, bad relationships with managers, and unsafe conditions in the job environment. In comparison with other work areas, this is one of the sectors with higher risk of problems related to alcohol use, mainly due to the availability of the substance in the work place, to the social pressure, to the working schedules, and to the way people cope with stress at work. Due to movements, rhythm, and techniques used in the activities performed in this kind of job, it is possible to develop bones and muscles alterations, and because of constant changes in labor shifts circadian cycles suffer disruptions that lead to different somatic symptomatologies. Studies in workers have shown that problematic alcohol consumption is present in 33-44% of this population. Other studies have found prevalences up to 24% of mental disorders in workers. The Department of Labor has reported that, as part of work diseases, mental and behavioral disorders increased its prevalence of 0.3% in 1999 to 1.9% in 2003. On the other hand, some studies report an association between mental disorders, somatization, and alcohol use in general population. People spend a considerable portion of their lives at their work places and working in gastronomic and hotel industry implies high risk for health. The objective of this paper is to know the association among alcohol use, the number of symptoms regarding mental health problems, and the level of discomfort caused by somatic symptoms in a sample of gastronomic and hotel industry workers from Mexico City. Material and method Population and sample Sampling was non-random, on convenience, and by quota. The sample included 194 men, over 18 years old, who were working at companies from the gastronomic and hotel industry in Mexico City. Most of the subjects were under 45 years old, over half of them studied until junior high school. The most frequent position among the subjects was waiter. Working days vary, depending on the day and time banquets and receptions are programmed. Over two thirds of the subjects mentioned having three or less years working in this kind of job. Questionnaire The short version of the AUDIT (first three questions) was used to establish the level of alcohol use. This version allows to rate subjects in three levels, according to the amount and frequency of consumption: low risk use, risk use, and dangerous use. The five-item Mental Health Inventory (MHI-5) was used to determine the presence of mental health problems. The MHI-5 is a screening test that measures non-psychotic affective disorders, according to DSM-IV criteria, with no reference to specific disorders. The Symptoms Check List-90 (SCL-90) was used to identify psychological stress derived from somatic symptoms. The three scales have good levels of reliability and validity. The field team talked to the managers of the training department at the union, because all the subjects in the sample were affiliated, to get permission to collect the information. No invasive techniques were used nor any other type of intervention. Subjects responded to the questionnaire gathered in groups inside a training room. The fieldwork involved trained interviewers, whose training was voluntary. All the workers accepted to participate and to respond the questionnaire through a verbal agreement. Participation was anonymous and neither the union representatives nor the managers had access to individual questionnaires, which granted confidentiality. The union representatives acknowledged a global report that intended to make them aware of the magnitude of the alcohol use and mental health problems among their affiliates. SPSS 10 software was used to analyze data. Results A total of 44.2% of the subjects reported drinking four or more drinks per occasion; 60.9% of them mentioned they had drunk six or more drinks per occasion during the last year; 55.5% of the workers were located in a low risk consumption level; 43.1% had a risky consumption level, and 10.4% consumed at a dangerous level. Results regarding mental health showed that a quarter of the subjects «have felt uneasy¼ (26.1%), 16.7% «have felt happy¼, 9.7% «have felt sad and melancholic¼, 8.4% «have felt down or as if nothing could cheer them up¼, and 4.3% «have been very nervous¼. A cut-off score of 16 or higher allowed identifying 11% of cases with symptoms of a possible mental health problem. Most of the subjects (69.6%) mentioned having experienced at least one somatic symptom during the last month. The ones that caused more discomfort were muscular pain (17.6%), backaches (12%), headaches (9.7%), weakness in some part of the body (7.1%), and nausea (6.7%). A cut-off score of eight or higher allowed to identify 14.7% of cases with somatic symptomatology that caused psychological distress. A Pearson correlation analysis was performed and the results showed a significant association between the level of alcohol consumption and the discomfort due to somatic symptoms (pr=.404^><.01). Significant associations were also found between the mental health state and the discomfort due to somatic symptoms (pr=.339 ^><.01), and between the level of alcohol consumption and the mental health state (pr=.260 ^><.01). Discussion and conclusions The percentage of alcohol consumers, the amount of alcohol consumed, the frequency of consumption, and the prevalence of problematic consumption were higher in this group of workers when compared to employees from other occupations. This can be the result of a mayor substance availability within gastronomic and hotel work environments. The association between alcohol use and the number of symptoms of mental health problems may be an indicator of co-morbidity between both conditions. It is also possible that the association is related to excessive alcohol use as a way to cope with emotional problems. The somatic symptoms with the highest prevalence were part of the somatization scale, but there is a possibility that they are indicators of an illness or disease derived from the labor activity instead of indicators of somatic symptoms. On the other hand, whether alcohol use increases frequency of mental and physical troubles or that consumption is present as a reaction to these troubles, more research is necessary to know more about these variables co-morbidity because these relate to the presence of accidents, problems at work, social and family problems, as well as economic burden. The use of screening scales in working settings is important because it reduces costs and helps to identify related problems. In addition, they are easy to use at factories and businesses without interfering with the manufacturing processes. Nevertheless, it is important to use more specific instruments with identified cases. This would permit a more precise diagnosis and, if necessary, to refer subjects to institutions that provide specialized health care. To have such a structure would reinforce protective factors for subjects to cope with the risks inherent to their professional activity. Limitations and suggestions Conclusions are valid only for the workers in this sample because of the sampling method and they cannot be applied to all the workers of the gastronomic and hotel industry. So far, studies about substance use in working settings have focused on men population; however, women are an important segment that researchers should consider investigating to collect information that can sustain proper and necessary actions.

Burnout y síntomas somáticos cardiovasculares en enfermeras de una institución de salud en el Distrito Federal / Burnout syndrome and cardiovascular somatic symptoms in nurses from a health facility in the Distrito Federal

Introducción: El Burnout se presenta con relativa frecuencia en el personal que labora en instituciones de salud como una respuesta psicosocial afectiva de encontrarse emocionalmente agotado, se manifiesta por actitudes y sentimientos negativos hacia las personas con las que se trabaja. Objetivos: 1) Identificar el nivel de Burnout en un grupo de enfermeras de una institución de salud en el Distrito Federal; 2) Determinar la relación entre el Síndrome de Burnout, los síntomas somáticos cardiovasculares y las cifras de presión arterial. Metodología: En 109 enfermeras, se evaluó el nivel de Burnout con el Cuestionario Maslach Burnout Inventory-General Survey (MBIG-S) en versión CORE con dos subescalas: agotamiento emocional (0.85) y despersonalización (0.78); un cuestionario de síntomas cardiovasculares y un protocolo de puntos estimados de presión arterial puntual en el puesto de trabajo. Resultados: En 67% de las enfermeras predominó el Burnout en nivel medio; los niveles bajo y alto se presentaron en 19% y 14% respectivamente. Se obtuvo correlación significativa (r=348 p<0.01) entre los síntomas cardiovasculares y Burnout; al igual que con el componente de agotamiento emocional (r=374 p<0.01). La relación entre las cifras de TA y Burnout no fue significativa. Conclusiones: La relación significativa entre los síntomas cardiovasculares y Burnout, indican subjetivamente una primera manifestación de enfermedad cardiovascular, que posteriormente puede ser somatizada. En el caso de agotamiento emocional y síntomas cardiovasculares, se plantea la hipótesis de que a mayor cansancio físico y emocional percibido en y por el trabajo hay un aumento en la presencia de síntomas de enfermedad cardiovascular.

Introduction: Burnout syndrome is relatively often present in personnel who work in health facilities as an affective psychosocial response of showing oneself emotionally exhausted; it is manifested through negative attitudes and feelings toward workers. Cardiovascular diseases are de most significant among the produced physical alterations. Objectives: 1) To identify the level of Burnout Syndrome within a group of nurses in a health facility in the Distrito Federal; 2) To determine the relation between Burnout Syndrome, cardiovascular somatic symptoms, and blood pressure measurements. Methodology: In 109 nurses Burnout score was assessed through Maslach Burnout Inventory-General Survey (MBIG-S) Core version with two subscales: emotional tiredness(0.85) and depersonalization (0.78); a questionnaire of cardiovascular symptoms and a protocol of estimated points of blood pressure at work. Results: 67% of nurses were predominant with medium Burnout score; low and high levels were represented with 19% and 14% respectively. It was obtained a significant correlation (r=348 p<=0.01) between the cardiovascular symptoms and Burnout syndrome, as well as with the component of emotional tiredness (r=374 p<=0.01). The relation between blood pressure and Burnout Syndrome it did not show significance. Conclusions: The significant relation between cardiovascular symptoms and Burnout syndrome showed subjectively a first manifestation of cardiovascular disease which can be physically exposed latter. In the case of emotional tiredness and cardiovascular symptoms, a hypothesis is founded: as long as physical and emotional tiredness are perceived in and by working, there is an increment in presence of cardiovascular disease.