The metabolic syndrome and its constituting variables in atypical antipsychotic-treated subjects: comparison with other drug treatments, drug-free psychiatric patients, first-degree relatives and the general population in Venezuela.

BACKGROUND: Few studies on the association between atypical antipsychotic drug (AAP) administration and metabolic dysfunction have concurrently evaluated the general population (GP), other psychotropic drug treatments and drug-free psychiatric patients. METHODS: We assessed the frequency of the metabolic syndrome (MS) according to the National Cholesterol Education Program criteria (NCEP) and its constituting variables in a GP sample (n=271) and in patients receiving, for at least three consecutive months, antiepileptic drugs (n=93), olanzapine (n=162), clozapine (n=105), typical antipsychotics (n=117), other AAP (n=58), other psychotropic drugs (n=185), and drug-free individuals (n=636). Subjects were clinically classified as schizophrenia, bipolar or other axis I disorders (DSM-IV-RT), and as first-degree relatives of each diagnostic group. RESULTS: The MS was detected in 26.6% of the GP (95% confidence interval: 21.5-31.8). No diagnostic or treatment group had a significantly higher age-adjusted frequency than the GP (p>0.05). Treatment duration did not significantly affect the results. However, significant differences were observed in the frequency of abnormal MS constituting variables in comparison to the GP. For example, schizophrenia patients and their relatives, bipolar subjects and olanzapine- and clozapine-treated patients had higher abnormal waist circumference values. In addition, bipolar patients and their relatives and subjects treated with olanzapine and other AAPs had higher frequencies of abnormal glucose levels. Neither schizophrenia nor bipolar patients in the diagnostic categories nor the olanzapine or the clozapine groups displayed higher proportions of abnormal triglycerides, high density cholesterol or blood pressure levels than the GP. CONCLUSIONS: While we did not demonstrate an increased frequency of the MS in AAP-treated subjects, our results confirm that specific metabolic variables must be monitored in psychiatric patients. Besides they stress the importance, in epidemiological studies, of concurrently comparing the figures recorded in AAP-treated patients with those obtained in the local GP, other drug treatment groups and drug-free subjects when referring to the magnitude of the metabolic effects of specific antipsychotic agents.

Prevalencia real de epilepsia en un programa de salud mental. Merida-Venezuela / Real prevalence of epilepsy in a mental health programme in Merida, Venezuela

Objetivos Esta investigación tuvo como objetivos: 1. Determinar precisión del diagnóstico de epilepsia entre Programa Salud Mental y la evaluación neurológica experta, en población rural del Estado Mérida; 2. Conocer la frecuencia de epilepsia según variables demográficas.3. Determinar el tipo de crisis epiléptica mas frecuente. Métodos Se aplicó un cuestionario y evaluación por neurólogos de la Clínica de Epilepsia-IAHULA, entre Marzo-Diciembre 2003 a la población previamente diagnosticada con epilepsia, por el programa de Salud Mental, en el medio rural. Resultados De 240 pacientes evaluados, se corroboró diagnóstico de epilepsia en 198, correspondiendo a 82,3 por ciento de validez del diagnóstico. El grupo etario con mayor frecuencia fue de 0-44 años, con un pico entre 15-24 años; respecto a clasificación de crisis epilépticas: generalizadas (53,5 por ciento), crisis focales con generalización secundaria (30,8 por ciento). Conclusiones Se obtuvo cifras elevadas de epilepsia, (precisión diagnóstica de 82,3 por ciento, respecto al Programa Salud Mental); estos pacientes no recibían atención neurológica, ni el beneficio de estudios complementarios pertinentes. El conocimiento de estos resultados, ha puesto en evidencia la necesidad del recurso neurológico para el Programa de Salud Mental, con el objeto de brindar una verdadera atención integral, al paciente con epilepsia en el estado Mérida.

Objectives Determining the accuracy of the mental health programme in diagnosing epilepsy and expert neurological evaluation in rural populations in the state of Mérida in Venezuela and ascertaining the most frequent types of epilepsy in the population being investigated. Methodology Neurologists from the IAHULA epilepsy clinic applied a questionnaire throughout May and December 2003 and evaluated the rural population previously diagnosed as suffering from epilepsy by the mental health programme. Results A diagnosis of epilepsy was confirmed in 198 of the 240 patients evaluated (82,3 percent diagnostic accuracy). Epilepsy was most frequent in the 0-44 age-range, peaking between 15-24 years. Epileptic seizures were classified as being generalised (53,5 percent) or focal seizures having secondary generalisation (30,8 percent). Conclusions Very high levels of epilepsy were obtained (82.3 percent diagnostic accuracy compared to the mental health programme); however, these patients did not receive neurological care or benefit from complementary studies. These results revealed the need for neurological resources for the mental health programme for providing comprehensive care for epilepsy patients in Mérida.

[Real prevalence of epilepsy in a mental health programme in Merida,Venezuela]. / Prevalencia real de epilepsia en un programa de salud mental. Merida-Venezuela.

OBJECTIVES: Determining the accuracy of the mental health programme in diagnosing epilepsy and expert neurological evaluation in rural populations in the state of Mérida in Venezuela and ascertaining the most frequent types of epilepsy in the population being investigated. METHODOLOGY: Neurologists from the IAHULA epilepsy clinic applied a questionnaire throughout May and December 2003 and evaluated the rural population previously diagnosed as suffering from epilepsy by the mental health programme. RESULTS: A diagnosis of epilepsy was confirmed in 198 of the 240 patients evaluated (82,3 % diagnostic accuracy). Epilepsy was most frequent in the 0-44 age-range, peaking between 15-24 years. Epileptic seizures were classified as being generalised (53,5 %) or focal seizures having secondary generalisation (30,8 %). CONCLUSIONS: Very high levels of epilepsy were obtained (82.3% diagnostic accuracy compared to the mental health programme); however, these patients did not receive neurological care or benefit from complementary studies. These results revealed the need for neurological resources for the mental health programme for providing comprehensive care for epilepsy patients in Mérida.

Prevalencia de la migraña en estudiantes de educación basica y media de Mérida, Venezuela / The prevalence of migraines among primary-and secondary-school students in Mérida, Venezuela

Objetivo. Determinar la prevalencia de la migraña en una población estudiantil del Municipio Libertador (Mérida, Venezuela), el efecto incapacitante de la cafalea en general y la proporción de individuos que se automedican. Métodos. Se aplicó una autoencuesta a una muestra de 1714 alumnos de 10 a 21 años de edad seleccionada por muestreo estratificado y aleatorio simple. Resultados. La prevalencia de la cafalea fue de 84,4 por ciento, y la de la migraña no tuvo un efecto incapacitante importante en esta población. De los estudiantes con cefalea, 69,2 por ciento no solicitaron asistencia médica y 80,3 por ciento se automedicaron. Conclusiones. La migraña es muy frecuente y las cifras de automedicación y carencia médica indican que debe existir un déficit de cobertura de los servicios de salud y desinformación de la población que ocasiona un subregistro de la cefalea

Prevalencia de la migraña en estudiantes de educación básica y media de Mérida, Venezuela / The prevalence of migraines among primary-and secondary-school students in Mérida, Venezuela

Objetivo. Determinar la prevalencia de la migraña en una población estudiantil del Municipio Libertador (Mérida, Venezuela), el efecto incapacitante de la cafalea en general y la proporción de individuos que se automedican. Métodos. Se aplicó una autoencuesta a una muestra de 1714 alumnos de 10 a 21 años de edad seleccionada por muestreo estratificado y aleatorio simple. Resultados. La prevalencia de la cafalea fue de 84,4 por ciento, y la de la migraña no tuvo un efecto incapacitante importante en esta población. De los estudiantes con cefalea, 69,2 por ciento no solicitaron asistencia médica y 80,3 por ciento se automedicaron. Conclusiones. La migraña es muy frecuente y las cifras de automedicación y carencia médica indican que debe existir un déficit de cobertura de los servicios de salud y desinformación de la población que ocasiona un subregistro de la cefalea