The incidence of non-affective psychotic disorders in Chile between 2005 and 2018: results from a national register of over 30 000 cases.

BACKGROUND: Evidence suggests the incidence of non-affective psychotic disorders (NAPDs) varies across persons and places, but data from the Global South is scarce. We aimed to estimate the treated incidence of NAPD in Chile, and variance by person, place and time. METHODS: We used national register data from Chile including all people, 10-65 years, with the first episode of NAPD (International Classification of Diseases, Tenth Revision: F20-F29) between 1 January 2005 and 29 August 2018. Denominators were estimated from Chilean National Census data. Our main outcome was treated incidence of NAPD and age group, sex, calendar year and regional-level population density, multidimensional poverty and latitude were exposures of interest. RESULTS: We identified 32 358 NAPD cases [12 136 (39.5%) women; median age-at-first-contact: 24 years (interquartile range 18-39 years)] during 171.1 million person-years [crude incidence: 18.9 per 100 000 person-years; 95% confidence interval (CI) 18.7-19.1]. Multilevel Poisson regression identified a strong age-sex interaction in incidence, with rates peaking in men (57.6 per 100 000 person-years; 95% CI 56.0-59.2) and women (29.5 per 100 000 person-years; 95% CI 28.4-30.7) between 15 and 19 years old. Rates also decreased (non-linearly) over time for women, but not men. We observed a non-linear association with multidimensional poverty and latitude, with the highest rates in the poorest regions and those immediately south of Santiago; no association with regional population density was observed. CONCLUSION: Our findings inform the aetiology of NAPDs, replicating typical associations with age, sex and multidimensional poverty in a Global South context. The absence of association with population density suggests this risk may be context-dependent.

Duration of untreated psychosis and acute remission of negative symptoms in a South American first-episode psychosis cohort.

AIM: To determine the association between duration of untreated psychosis (DUP) and symptoms remission in a hospitalized first-episode psychosis cohort. METHODS: Inpatients with a first-episode non-affective psychosis were recruited. Subjects were divided into two groups of long and short DUP using a 3-month cut-off point, and this was related to remission at 10 weeks of treatment. Multivariate analyses were performed. RESULTS: Fifty-five inpatients were included. There were no differences in remission rates of positive symptoms. Up to 76.5% of the patients with a short DUP (<3 months) achieved remission of negative symptoms versus 31.6% in the DUP ≥ 3 months group (P = 0.003). After controlling for relevant factors, patients with a shorter DUP were still three times more likely to achieve negative symptoms remission (HR: 3.04, 95% CI 1.2-7.5). CONCLUSIONS: DUP is a prognostic factor that should be considered at an early stage to identify a 'high risk' subgroup of persistent negative symptoms.

Hábitat urbano y salud mental en el gran Santiago: Resultados preliminares / Urban habitat and mental health in the great Santiago: Preliminary results

Objetivo. Determinar posibles asociaciones entre características físicas del barrio en que se vive y la salud mental de sus habitanes en el Gran Santiago. Metodología. La salud mental de la población se extrajo de la base de datos del estudio "Salud Mental en el Gran Santiago", que utilizó como marco muestral la población adulta entre 16 y 64 años residente en viviendas particulares en la comunas del Gran Santiago (N=3.237.286). Para medir el hábitat urbano se confeccionó una encuesta que midió las siguientes variables: iluminación, calles, áreas verdes, contaminación, estado, tipología y ornamentación de las construcciones del sector, infraestructura y seguridad. Resultados. El análisis de regresión logística entre todos los factores analizados-factores individuales sociodemográficos y factores de hábitat urbano-indica que las variables que se asocian significativamente en forma independiente con la presencia de un trastorno mental común son: percibir bajos ingresos y vivir en una vivienda de baja calidad. Conclusiones. Las variables del hábitat urbano aquí estudiadas no influyen en la salud mental de las personas, la que sí se ve afectada por factores individuales.

Depresión y discapacidad laboral / Depression and working disability

Los trastornos depresivos son altamente prevalentes en la población general y constituyen un gran problema de salud pública. En Santiago la prevalencia es del orden del 5,5 por ciento en la población adulta. Estimaciones de la OMS indican que, para el año 2020, la enfermedad depresiva será la segunda causa de años de vida perdidos por razones de salud a nivel mundial. En la fuerza laboralmente activa es una enfermedad frecuente, afectando la productividad y generando costos importantes a la sociedad. Un tratamiento antidepresivo mejora la funcionalidad y productividad delas personas, razón por la cual se hace necesario implementar tratamientos de las personas laboralmente activas.