Impacto de problemas de salud mental y apoyo social en la calidad de sueño: Seguimiento longitudinal antes y durante la pandemia de COVID-19 en universitarios chilenos / Impact of mental health problems and social support on sleep quali-ty: Follow-up before and during the first eight months of the COVID-19 pandemic in Chilean university student

Introducción: Antecedentes refieren altos índices de problemas de salud mental en universitarios antes y durante la pandemia por COVID-19, con efectos sobre la baja calidad de sueño; sin embargo, el apoyo social percibido actuaría como un factor protector. Objetivo: Evaluar el impacto de la salud mental (ansiedad, depresión y estrés) sobre la calidad de sueño, de forma transversal y longitudinal, antes y durante la pandemia por COVID-19 en universitarios chilenos, verificando si el apoyo social percibido podría moderar esta relación. Material y Métodos: 1.619 universitarios en el año 2019 y 1.862 en el año 2020 respondieron cuestionarios orientados a medir depresión, ansiedad, estrés, calidad del sueño y apoyo social percibido. Con una fracción de la muestra que respondió en ambos años (n = 325) se realizó análisis longitudinal y se contrastaron los puntajes de los instrumentos entre ambos años, mediante una matriz de transición y un modelo de regresión múltiple. Resultados: Se encuentran altas prevalencias de problemas de salud mental, aumentando en el año 2020 la sintomatología moderada y grave. Se agudizan los problemas de sueño y la percepción de bajo apoyo social. Todas las variables de salud mental pueden predecir la calidad del sueño, excepto el apoyo social y longitudinalmente, aumenta la severidad de la baja calidad de sueño y la depresión. No se encuentran moderaciones significativas entre apoyo social percibido y el resto de las variables. Conclusiones: El efecto de la pandemia en la salud mental es complejo, requiriéndose acciones concretas para apoyar psicológicamente a los estudiantes.(AU)

Introduction: Research has revealed high rates of mental health problems in university students before and during the COVID-19 pan-demic, with effects on poor sleep quality; however, perceived social sup-port appears to act as a protective factor. Objective: To assess the impact of mental health (anxiety, depression, and stress) on sleep quality, cross-sectionally and longitudinally, before and during the COVID-19 pandemic in Chilean university students, verifying whether perceived social support could act as a moderatorin this relationship.Material and Methods: 1,619 university students in 2019 and 1,862 in 2020 answered questionnaires aimed at measuring depression, anxiety, stress, sleep quality, and perceived social support. Longitudinal analysis was per-formed with afraction of the sample that responded in both years (n= 325). The scores of the instruments for both years were contrasted using a transition matrix and a multiple regression model. Results: High prevalence rates of mental health problems were found, with moderate and severe symptoms increasing in 2020. Sleep problems and the perception of low social support worsened. All mental health variables were found to predict sleep quality except for social support; longitudinally, the severity of poor sleep quality and depression increased. No significant moderation effects were found between perceived social support and the rest of the variables. Conclusions: The effect of the pandemic on mental health is complex, re-quiring concrete actions to provide students with psychological suppor.(AU)

Resultados de una evaluación y seguimiento online de problemas de salud mental en universitarios chilenos / Results of an online mental health problems screening and follow-up with Chilean university students

Resumen Este estudio examina la detección y posterior seguimiento online de problemas de salud mental en estudiantes universitarios y expone los resultados de ambos procesos. Para ello, se aplicó a través de la plataforma de la universidad a 1 707 estudiantes una batería de cuestionarios destinados a detectar desesperanza y riesgo de suicidio, síntomas depresivos y ansiosos, estrés, trastornos de la conducta alimentaria y apoyo social percibido. Una vez aplicados los instrumentos, los estudiantes recibían una retroalimentación acerca de sus niveles de síntomas e información acerca de redes y establecimientos para buscar ayuda y recibir atención en los casos requeridos. A mediados del año siguiente, se realizó una encuesta de seguimiento a 577 de los estudiantes que previamente habían respondido todos los cuestionarios. Los resultados de la batería de cuestionarios aplicados indican altos índices de problemas de salud mental, con diferencias estadísticamente significativas según sexo, siendo las mujeres quienes presentan mayor prevalencia. Estos resultados concuerdan con diversos estudios que muestran altos porcentajes de síntomas de problemas de salud mental en los universitarios. A su vez, el posterior seguimiento permitió evidenciar que el feedback entregado activó la búsqueda de ayuda, y se obtuvieron correlaciones positivas entre sentirse mejor y haber buscado un tratamiento de salud mental o haber pedido ayuda a los amigos o a la familia. El uso de tecnologías de la información en la detección y prevención de salud mental tendría un alcance positivo y resultó ser una herramienta útil, accesible y cercana para los jóvenes.

Abstract The exponential increase in higher education students and the new university profile that incorporates more vulnerable social groups are associated with an increase in mental health problems in this population. Likewise, the complex stage of the life cycle in which these young people find themselves and the stress of the transition between adolescence and adulthood are other risk factors for the development of mental health problems. The emergence of mental health problems in this group could then be due to a confluence of factors, also facilitating risk behaviors. National and international researches have reported the worrying rates of mental health disorders in university students, mainly in relation to the presence of depression, anxiety, stress, alcohol or drug use, eating disorders, and suicidal ideation. These disorders tend to be aggravated, because the university population is prone not to seek help. The stigma of presenting mental health problems, skepticism about treatments, not wanting to worry the closest family and the few economic resources or not having a health plan, lead to not seeking help or do this late. Studies have found that more than half of students who need mental health and support services are not receiving them. On the other hand, a high percentage seeks help late, which implies that the disorders are accentuated or become chronic, which makes subsequent treatment and improvement difficult, even becoming a public health problem due to the high economic and professional demand that these treatments require.

Social and Economic Factors Associated With Subthreshold and Major Depressive Episode in University Students During the COVID-19 Pandemic.

Depression is one of the most frequent mental health disorders in college students and variations according to social and economic factors have been reported, however, whether social and economic variations also exist in subthreshold depression is still unknown, especially during the COVID-19 pandemic. The aim of this study was to estimate the prevalence of subthreshold depressive episode (SDE) and major depressive episode (MDE) and to examine the association between social and economic factors with SDE and MDE in undergraduate students during the COVID-19 pandemic. The participants were 1,577 college students from a university in the south of Chile (64.6% females, 22 years old on average). The participants took an online survey in November 2020 which collected information about social and economic variables, depressive symptoms, and perceived social support. Bivariate and multinomial logistic regression analysis were used. The results showed a high prevalence of SDE (14.3%) and MDE (32.3%) in the sample. Belonging to a social group and perceiving positive social support were the only variables examined that were associated with SDE. Instead, female sex, poorer quintiles, living with other relatives but not parents, economic difficulties due to the pandemic, being a parent, and perceiving positive social support were associated with MDE. Subthreshold and threshold depressive symptoms are frequent in college students, and associations with social and economic factors differ according to the level of such symptoms. These results should be considered in the development of tailored preventive and early interventions for depression in college students.

The sustained increase of mental health symptoms in Chilean university students over three years / Aumento sostenido de síntomas de salud mental durante tres años en estudiantes universitarios chilenos

Abstract Given the high rates of mental health problems within the general population and, particularly, the university population, the main goal of this paper is to determine the prevalence of symptoms related to mental health in students at the University Austral de Chile between 2015 and 2017. A convenience sample was taken with a non-experimental correlational design of a transversal character. The final samples were composed of 1631 students in the year 2015, 1518 in 2016 and 1707 in 2017. The Instruments used measured depression, anxiety, stress, hopelessness, alimentary restraint, and functional social support. Reliability analysis, descriptive and polynomial contrast analysis which searched for linear and quadratic trends through ANOVA were perform. The results indicate a sustained rise in the percentages of symptomologies and a decline in the perception of social support. There are also statistically significant differences between men and women surveyed, with women showing more symptoms of depression, anxiety and stress over the three years studied. The results are concurrent with findings on a global level concerning the prevalence of mental health problems in university students. This data has allowed university professionals to better direct their efforts in supporting and treating students and promoting health in general.

Resumen Dadas las altas tasas de problemas de salud mental en población general y en particular, en población universitaria, el objetivo principal de este estudio es determinar la prevalencia de síntomas de salud mental en estudiantes de la Universidad Austral de Chile entre los años 2015 y 2017. Se utilizó un muestreo por conveniencia, con un diseño correlacional no experimental de carácter transversal. Las muestras finales se compusieron de 1631 estudiantes en el año 2015, 1518 en 2016 y 1707 en 2017. Los instrumentos utilizados midieron depresión, ansiedad, estrés, desesperanza, restricción alimentaria y apoyo social funcional. Se realizaron análisis de confiabilidad, descriptivos y de contraste polinómico que buscaron tendencias lineales y cuadráticas a través de ANOVA. Los resultados indican un aumento sostenido en los porcentajes de sintomatologías y una disminución en la percepción del apoyo social. También hay diferencias estadísticamente significativas entre hombres y mujeres encuestados, siendo las mujeres quienes muestran más síntomas de depresión, ansiedad y estrés durante los tres años estudiados. Los resultados coinciden con los hallazgos a nivel mundial sobre la prevalencia de problemas de salud mental en estudiantes universitarios. Estos datos han permitido a los profesionales de la universidad dirigir mejor sus esfuerzos para apoyar y tratar a los estudiantes y promover la salud en general.

Suicidabilidad y apoyo social percibido en estudiantes universitarios con enfermedades crónicas no transmisibles / Suicidality and perceived social support in university students with chronic non-communicable diseases

Resumen El objetivo fue identificar las asociaciones entre apoyo social percibido, riesgo suicida y presencia de enfermedad crónica no transmisible en estudiantes universitarios. Utilizando un diseño de casos y controles, con 41 estudiantes universitarios por grupo. La mediana de edad fue de 22 años (R = 9), un 81,8% eran mujeres, el 26,8% de los sujetos tenía Asma y el 26,8% Hipotiroidismo, y el 63,6% pertenecía a la Facultad de Educación. No se comprobó la asociación entre enfermedad crónica, apoyo social, ni tampoco con riesgo suicida. Hay asociación indirecta entre riesgo suicida y apoyo social, no así cuando se evalúa el intento de suicidio previo. El nivel de riesgo suicida y apoyo social se asocian independiente de la presencia de enfermedad crónica. Esperamos que nuestros resultados permitan fomentar el apoyo social como una herramienta fundamental para la prevención de la suicidabilidad, especialmente en sujetos con enfermedad crónica.

Abstract The objective was to identify associations between perceived social support, suicidal risk and the presence of chronic or communicable disease in university students. Using a case-control design, consisting of 41 subjects in each group. The median age was 22 years (R = 9), 81,8% were women, 26,8% of the subjects had asthma and 26,8% had hypothyroidism, 63,6% were students of the faculties of Education. The association between chronic disease and social support was not proven, nor was there a suicidal risk. There is an indirect association between suicide risk and social support, not so when assessing the previous suicide attempt. The levels of suicide risk and social support are associated, independent of an existing chronic disease. We are hopeful that our results will be effective in promoting social support as a basic tool for suicide prevention, especially in subjects with chronic disease.

Reciprocity Between Parental Psychopathology and Oppositional Symptoms From Preschool to Middle Childhood.

OBJECTIVE: Oppositional defiant disorder (ODD) is a common disorder in preschool children. Evidence indicates that maternal and paternal psychopathology, particularly aggressive behavior and anxious and depressed symptoms, contributes to the development of this disorder. The latest research also suggests that ODD symptoms may exacerbate the mental health problems of parents. Our aim was to establish the existence of a reciprocal association between paternal and maternal psychopathology (aggression, depression, and anxiety) and child ODD at ages 3 and 8, using a longitudinal design in a community sample of preschoolers. METHOD: The sample included 331 children evaluated at ages 3 and 8 through questionnaires and a semistructured diagnostic interview with parents. Parents also informed about their own psychopathology. RESULTS: At 3 years of age, higher levels of ODD symptoms in girls were concurrently associated with maternal anxious and depressed symptoms and paternal aggressive behavior, and higher levels of ODD symptoms in boys were concurrently associated with maternal aggressive behavior. Longitudinally, for boys, higher levels of maternal anxious and depressed symptoms at child age 3 predicted increases in ODD symptoms from 3 to 8 years of age. In addition, higher levels of ODD symptoms in boys aged 3-8 years predicted increases in fathers' anxious and depressive symptoms. CONCLUSION: Children with ODD should be evaluated and treated promptly, but efforts should be extended to their parents. Mothers' and fathers' mental health must be explored because the psychopathologies of children and parents reciprocally affect each other.

[Mental health problems among students of a regional Chilean university]. / Problemas de salud mental en estudiantes de una universidad regional chilena.

BACKGROUND: The increase in university population in Chile has also increased the number of students presenting mental health disorders. AIM: To determine the frequency of mental health problems and its association with other relevant variables among students of a regional university in Chile. MATERIAL AND METHODS: A sample of 484 students aged 18 to 28 years (45% males) were assessed once using a battery of tests designed to detect mental health problems. The instruments used were Derogates SCL-90-R, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Depression, Anxiety and Stress Scales (DASS-21) and a social-demographic questionnaire. RESULTS: Fifteen percent of the sample presented high levels of mental health symptoms, determined according to the cut-off points of Beck inventories. This symptomatic group, which also showed high levels of stress, was composed mostly of freshmen and women. There was a significant association between symptoms and socio-demographic variables such as living in rural areas, ethnicity and socioeconomic status, a higher need for psychological and psychiatric care and a lower number of extracurricular activities. CONCLUSIONS: The knowledge of mental health problems among university students will allow to generate strategies for mental health prevention, promotion and treatment.

Problemas de salud mental en estudiantes de una universidad regional chilena / Mental health problems among students of a regional Chilean university

Background: The increase in university population in Chile has also increased the number of students presenting mental health disorders. Aim: To determine the frequency of mental health problems and its association with other relevant variables among students of a regional university in Chile. Material and Methods: A sample of 484 students aged 18 to 28 years (45% males) were assessed once using a battery of tests designed to detect mental health problems. The instruments used were Derogates SCL-90-R, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Depression, Anxiety and Stress Scales (DASS-21) and a social-demographic questionnaire. Results: Fifteen percent of the sample presented high levels of mental health symptoms, determined according to the cut-off points of Beck inventories. This symptomatic group, which also showed high levels of stress, was composed mostly of freshmen and women. There was a significant association between symptoms and socio-demographic variables such as living in rural areas, ethnicity and socioeconomic status, a higher need for psychological and psychiatric care and a lower number of extracurricular activities. Conclusions: The knowledge of mental health problems among university students will allow to generate strategies for mental health prevention, promotion and treatment.

Escalas de depresión, ansiedad y estrés (DASS - 21): validación de la versión abreviada en estudiantes universitarios chilenos / Depression anxiety Stress Scales (daSS – 21): validation of the abbreviated version in Chilean university students

Debido a la alta tasa de trastornos ansiosos, depresivos y estrés en universitarios, es necesario contar con un instrumento estandarizado en esta población, que permita detectar estas patologías para intervenir oportunamente. Por ello, el objetivo de este trabajo fue determinar las características psicométricas de las Escalas Abreviadas de Depresión, Ansiedad y Estrés (DASS - 21) en universitarios chilenos, lo cual contempló la validación del mismo. La muestra estuvo constituida por 484 estudiantes de la Universidad Austral de Chile, seleccionados mediante un muestreo probabilístico por conglomerados, utilizando un diseño correlacional transversal. La validez de constructo se verificó mediante análisis factorial exploratorio, el que arrojó una estructura de tres factores, explicando el 49,99 % de la varianza total. La validez concurrente y divergente fue verificada con el BAI, BDI - II y SCL - 90 - R. Mediante Alpha de Cronbach se constató la adecuada confiabilidad y consistencia interna del DASS - 21.

The high rate of anxiety disorders, depression and stress detected in Chilean university students requires a standardized instrument of diagnosis, enabling timely intervention for these disturbances. The aim of this study was to determine the psychometric properties of the Abbreviated Scales of Depression, Anxiety and Stress (DASS-21) for Chilean university students, thus validating the scale. The sample consisted of 484 students of Universidad Austral de Chile selected through random sampling using a cross-sectional correlation design. Construct validity was verified by exploratory factor analysis which yielded a three-factor structure, explaining 49.99% of total variance. Concurrent and divergent validity was verified by the BAI, BDI-II and SCL-90. Adequate reliability and internal consistency of DASS-21 was found using Cronbach's Alpha.