Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies.

BACKGROUND: Both stroke and psychosis are independently associated with high levels of disability. However, psychosis in the context of stroke has been under-researched. To date, there are no general population studies on their joint prevalence and association. AIMS: To estimate the joint prevalence of stroke and psychosis and their statistical association using nationally representative psychiatric epidemiology studies from two high-income countries (the UK and the USA) and two middle-income countries (Chile and Colombia) and, subsequently, in a combined-countries data-set. METHOD: Prevalences were calculated with 95% confidence intervals. Statistical associations between stroke and psychosis and between stroke and psychotic symptoms were tested using regression models. Overall estimates were calculated using an individual participant level meta-analysis on the combined-countries data-set. The analysis is available online as a computational notebook. RESULTS: The overall prevalence of probable psychosis in stroke was 3.81% (95% CI 2.34-5.82) and that of stroke in probable psychosis was 3.15% (95% CI 1.94-4.83). The odds ratio of the adjusted association between stroke and probable psychosis was 3.32 (95% CI 2.05-5.38). On the individual symptom level, paranoia, hallucinated voices and thought passivity delusion were associated with stroke in the unadjusted and adjusted analyses. CONCLUSIONS: Rates of association between psychosis and stroke suggest there is likely to be a high clinical need group who are under-researched and may be poorly served by existing services.

Factores relacionados con el resultado de los tratamientos endodónticos realizados en una institución universitaria con odontólogos en formación / Factors related to the result of endodontic treatments performed in a university institution with dentists in training / Fatores relacionados ao resultado de tratamentos endodônticos realizados em instituição universitária com dentistas em treinamento

Resumen Introducción y objetivo: el tratamiento endodóntico se realiza para tratar la enfermedad pulpoperiapical y puede tener un porcentaje de éxito de más del 90% en condiciones ideales para su realización. Dentro de los factores que condicionan la práctica clínica, se encuentran la anatomía interna del diente, las habilidades del operador, el conocimiento de la técnica, los instrumentos empleados y el tiempo operatorio. El éxito lo determina la supervivencia y la ausencia de signos clínicos y radiográficos en el seguimiento. Determinar los factores asociados al resultado del tratamiento de endodoncia, realizado por estudiantes de pregrado en odontología de una universidad colombiana. Materiales y métodos: estudio de cohorte retrospectivo con una cohorte expuesta y una no expuesta a la periodontitis apical. Se evaluaron clínica y radiográficamente todos los pacientes cuyo motivo de consulta fue endodoncia durante los años 2013-2014. Resultados: la media de edad de los pacientes fue 51,23 (DE = 14,23) con un mayor porcentaje de participación de mujeres (71,1%). En el diagnóstico inicial se encontró un 26% de dientes con Periodontitis apical. Se encontró asociación entre una mediana mayor de consultas y no presentar Periodontitis apical al final del tratamiento. En los análisis bivariados y multivariados se encontró asociación de la presencia de accidentes y endodoncia suboturada con la presencia de Periodontitis apical al final del tratamiento. Conclusión: seguir protocolos y guía de atención que permitan evitar los accidentes y conservar la adecuada longitud en la conformación y obturación pueden incrementar la frecuencia de éxito en los tratamientos.

Abstract Introduction and objetive: an endodontic treatment is performed to treat pulp-periapical disorders and may have a success rate of over 90% under ideal conditions. Among the factors that need to be considered, knowledge of the internal anatomy of the root, operator skills, selected technique, instruments involved and surgical time are the most important to determine the success of such treatment. Success implies the survival of the tooth in the oral cavity as well as the absence of clinical and radiographic signs and symptoms. The purpose of this work was to determine the factors associated to the success of an endodontic treatment performed by undergraduate dental students in a Colombian university. Materials and methods: a retrospective study with cohorts exposed and unexposed to apical periodontitis was carried out. Patients who consulted for endodontic treatment in 2013-2014 were invited to participate and were assessed both clinically and radiographically. Results: mean age was 51.23 (SD 14.23) years and higher percentage of female participation (71.1%) was observed. At initial diagnosis, 26% of teeth were diagnosed with apical periodontitis. An association between a high consultation mean and absence of apical periodontitis at the end of treatment was found. Bivariate and multivariate analyses showed an association between the presence of procedure accidents and under-filled root canal obturation with the presence of apical periodontitis at the end of treatment. Conclusion: success rate of endodontic treatments may be increased by carefully following protocols and attention guidelines to reduce the possibility of accidents and to keep an adequate length of the canal filling.

Resumo Introdução e objetivo: um tratamento endodôntico é realizado para tratar distúrbios pulpar-periapicais e pode ter uma taxa de sucesso superior a 90% em condições ideais. Entre os fatores que precisam ser considerados, o conhecimento da anatomia interna da raiz, as habilidades do operador, a técnica selecionada, os instrumentos envolvidos e o tempo cirúrgico são os mais importantes para determinar o sucesso desse tratamento. O sucesso implica a sobrevivência do dente na cavidade oral, bem como a ausência de sinais e sintomas clínicos e radiográficos. O objetivo deste trabalho foi determinar os fatores associados ao sucesso de um tratamento endodôntico realizado por estudantes de graduação em odontologia de uma universidade colombiana. Materiais e métodos: estudo retrospectivo com coortes expostas e não expostas à periodontite apical. Os pacientes que consultaram para tratamento endodôntico em 2013-2014 foram convidados a participar e foram avaliados clinicamente e radiograficamente. Resultados: a média de idade foi de 51,23 (DP 14,23) anos e maior percentual de participação feminina (71,1%). No diagnóstico inicial, 26% dos dentes foram diagnosticados com periodontite apical. Foi encontrada associação entre alta média de consulta e ausência de periodontite apical ao final do tratamento. As análises bivariadas e multivariadas mostraram associação entre a presença de acidentes do procedimento e a obturação do canal radicular com preenchimento insuficiente com a presença de periodontite apical ao final do tratamento. Conclusão: a taxa de sucesso dos tratamentos endodônticos pode ser aumentada seguindo-se cuidadosamente os protocolos e diretrizes de atenção para reduzir a possibilidade de acidentes e manter um comprimento adequado do preenchimento do canal.

Ichthyosis: case report in a Colombian man with genetic alterations in ABCA12 and HRNR genes.

BACKGROUND: Ichthyosis is a heterogeneous group of diseases caused by genetic disorders related to skin formation. They are characterized by generalized dry skin, scaling, hyperkeratosis and frequently associated with erythroderma. Among its different types, harlequin ichthyosis (HI) stands out due to its severity. HI is caused by mutations in the ABCA12 gene, which encodes essential proteins in epidermal lipid transport, and it helps maintain the homeostasis of the stratum corneum of the epidermis. However, due to the wide spectrum of genetic alterations that can cause ichthyosis, holistic medical care, and genetic studies are required to improve the diagnosis and outcomes of these diseases. CASE PRESENTATION: Here, we presented the case of a 19 years old male patient who was a premature infant and exhibited clinical features consistent with HI, including bright yellow hyperkeratotic plates with erythematous fissures that covered his entire body like a collodion baby. Currently, he exhibited erythroderma, photosensitivity, ectropion, auricular pavilion alterations, and musculoskeletal disorders, such as equinovarus feet, fingers, hands, and hypoplastic feet with contractures in flexion and marked difficulty in fine motor skills. In addition, he presented dyschromatopsia, Achilles reflex hyporeflexia, slight speech, dental alteration and deficient cognitive performance. After the genetic sequencing, variants were found in ABCA12 and HRNR which are related to several skin diseases, including ichthyosis. CONCLUSIONS: Although in clinical practice, ichthyosis is a common entity, a severe type of ichthyosis is presented, highlighting the importance of appropriate genetic diagnosis, given the broad spectrum of genetic alterations with similar phenotypic and clinical characteristics. These pathologies must be known to guarantee initial support measures to prevent complications and offer multidisciplinary management to those patients.

Invarianza factorial del Launay-Slade Hallucinations Scale entre hombres y mujeres colombianos / Factorial invariance of the Launay-Slade Hallucinations Scale among Colombian male and female

Resumen Introducción: La Launay-Slade Hallucinations Scale (LSHS) es una de las pruebas más utilizadas en el estudio de las alucinaciones. Su estructura factorial ha sido descrita en diversas culturas, tanto en población general como población clínica. No obstante, pocos estudios han aportado evidencia de la equivalencia factorial con relación al sexo de los evaluados. El objetivo de esta investigación fue realizar un análisis de invarianza de medición y estructural de la LSHS-R en una muestra incidental de hombres y mujeres de población general colombiana. Método: Estudio instrumental en el cual participaron 350 habitantes de la ciudad de Medellín (Colombia), en su mayoría mujeres (64,3%), de edad promedio 28,62 años. Se realizaron análisis descriptivos de los ítems antes de realizar el análisis de invarianza de medición e invarianza estructural entre las muestras de hombres y mujeres. Resultados: El modelo de dos dimensiones reportado previamente en población colombiana presentaba los mejores índices de ajuste empírico para hombres y mujeres. Posteriormente, fue obtenida evidencia de invarianza configuracional, métrica y fuerte (invarianza de medición), además de igualdad de covarianzas y medias latentes (invarianza estructural) entre hombres y mujeres. Por otro lado, la LSHS-R presenta índices de confiabilidad aceptables. Conclusiones: La estructura de dos dimensiones de la LSHS-R así como la relación entre factores son estadísticamente equivalentes entre hombres y mujeres.

Introduction: The Launay-Slade Hallucinations Scale (LSHS) is one of the most used tests in the hallucinations study. Its factorial structure has been described in different cultures, in the general and the clinical population. However, few studies have provided evidence of factorial equivalence regarding the sex. The aim of this investigation was to perform a measurement and structural invariance analysis of LSHS-R in an incidental sample of men and women of Colombian general population. Method: This instrumental study involving 350 inhabitants of the city of Medellín (Colombia), mostly women (64.3%), with an average age of 28.62 years. Descriptive analyzes of the items were performed before performing the analysis of invariance of measurement and structural invariance between the samples of men and women. Results: The previously reported two-dimensional model in the Colombian population, presented the best empirical adjustment indexes for men and women. Later, was obtained evidence of configurational, metric and strong invariance (measurement invariance), as well as equality of covariances and latent means (structural invariance), between men and women. On the other hand, the LSHS-R has acceptable reliability indexes. Conclusions: The two-dimensional structure of LSHS-R as well as the relationship between factors are statistically equivalent between men and women.

Armed conflict and mental health in Colombia.

Although significant progress has been made in the peace process, Colombia still experiences high levels of ongoing violence and a legacy of more than five decades of armed conflict. Epidemiological studies show markedly raised levels of mental health problems in people affected by the conflict, with internally displaced people being a large and important group with unmet needs. Provision of mental health services is uneven and subject to significant underinvestment. Priority mental health treatment for victims of the conflict is now established in law, although the effectiveness of these programmes has yet to be established.

Validation of the Spanish-language Cardiff Anomalous Perception Scale.

The Cardiff Anomalous Perceptions Scale (CAPS) is a psychometric measure of hallucinatory experience. It has been widely used in English and used in initial studies in Spanish but a full validation study has not yet been published. We report a validation study of the Spanish-language CAPS, conducted in both Spain and Colombia to cover both European and Latin American Spanish. The Spanish-language version of the CAPS was produced through back translation with slight modifications made for local dialects. In Spain, 329 non-clinical participants completed the CAPS along with 40 patients with psychosis. In Colombia, 190 non-clinical participants completed the CAPS along with 21 patients with psychosis. Participants completed other psychometric scales measuring psychosis-like experience to additionally test convergent and divergent validity. The Spanish-language CAPS was found to have good internal reliability. Test-retest reliability was slightly below the cut-off, although could only be tested in the Spanish non-clinical sample. The scale showed solid construct validity and a principal components analysis broadly replicated previously reported three component factor structures for the CAPS.

Calidad de las historias clínicas de los practicantes de un consultorio psicológico de una universidad colombiana / Quality of the clinical notes of internship students in a psychology clinic of a Colombian university

INTRODUCCIÓN: Las prácticas académicas en los programas de psicología en Colombia constituyen una parte fundamental del currículo. Los consultorios psicológicos universitarios son un escenario en el cual se desarrolla esta actividad en el campo de la psicología clínica, por lo que se hace necesario revisar la información que se recauda allí, con vistas a supervisar la calidad de dichas prácticas. MÉTODO: Estudio exploratorio retrospectivo en el cual se analizaron los motivos de consulta, los diagnósticos, las estrategias de evaluación e intervención, las metas terapéuticas y los datos sociodemográficos de 708 historias clínicas diligenciadas entre 1999 y 2012 por estudiantes de últimos semestres en periodo de prácticas en una universidad colombiana. RESULTADOS: Se encontró que los diagnósticos están referidos en su mayoría a estresores psicosociales, más que a psicopatologías, y tanto las herramientas de diagnóstico como las estrategias de intervención no son coherentes con el diagnóstico registrado en la historia clínica. CONCLUSIONES: Es evidente la necesidad de fortalecer la formación básica en psicología clínica, en cuanto a sus métodos y alcances, de forma que se brinde una atención a los usuarios que tenga bases científicas, así como establecer protocolos de control para la supervisión de estudiantes en prácticas clínicas en la formación de pregrado

INTRODUCTION: Academic internships in psychology programs in Colombia are a fundamental part of the curriculum. University Psychological Services are a scenario in which this activity is developed in the field of clinical psychology, making it necessary to review the information collected there in order to monitor the quality of such practices. METHOD: A retrospective exploratory study in which the reasons for consultation, diagnoses, strategies of evaluation and intervention, therapeutic goals and sociodemographic data of 708 medical records were analysed, between 1999 and 2012, by students in the final semesters of the internship period in a Colombian university. RESULTS: It was found that the diagnoses mostly referred to psychosocial stressors rather than psychopathologies. The diagnostic tools and intervention strategies are not consistent with the diagnosis recorded in the clinical notes. CONCLUSIONS: The need to strengthen basic training in clinical psychology is evident, in terms of its methods and scope, in order to provide users with a scientific basis, as well as to establish control protocols for the supervision of students in Clinical internships in undergraduate training

Perception of risk as a mediator between personality and perception of health: test of a model.

BACKGROUND: This research article addresses the relationships among personality, risk perception, and health perception. The personality construct has been one of the main topics of research in psychology throughout history and is understood as the set of traits or cognitive, affective and behavioral characteristics that an individual possesses. Important relationships have been found that show the impact of personality on people's health as well as the impact of health conditions on the configuration of personality. This research investigates the perception of risk as a mediating trait between personality and perception of health. MATERIALS AND METHODS: To achieve this, a cross-sectional study was conducted in which 398 Colombians from all regions of the country were evaluated. The NEO Five Factor Inventory (NEO-FFI), The General Health Questionnaire (GHQ-12) and Health Risk Perception Test (HRPT) tests were used. RESULTS: The data were analyzed with multiple regression and path analysis. The findings using multiple regression show that neuroticism and the personal meaning of risk affect the perception of health; however, using path analysis, model fit with the proposed model was not achieved with no mediator effect of perception of risk. CONCLUSION: It is necessary to focus on relationships between neuroticism and perception of health in future research.

[Multidimensionality of inner speech and its relationship with abnormal perceptions]. / Multidimensionalidad del Habla Interna y su relación con las percepciones anómalas.

BACKGROUND: Inner speech is a common human experience. Recently, there have been studies linking this experience with cognitive functions, such as problem solving, reading, writing, autobiographical memory, and some disorders, such as anxiety and depression. In addition, inner speech is recognised as the main source of auditory hallucinations. OBJECTIVES: The main purpose of this study is to establish the factor structure of Varieties of Inner Speech Questionnaire (VISQ) in a sample of the Colombian population. Furthermore, it aims at establishing a link between VISQ and abnormal perceptions. METHOD: This was a cross-sectional study in which 232 college students were assessed using the VISQ and the Cardiff Anomalous Perceptions Scale (CAPS). RESULTS: Through an exploratory factor analysis, a structure of three factors was found: Other Voices in the Internal Speech, Condensed Inner speech, and Dialogical/Evaluative Inner speech, all of them with acceptable levels of reliability. Gender differences were found in the second and third factor, with higher averages for women. Positive correlations were found among the three VISQ and the two CAPS factors: Multimodal Perceptual Alterations and Experiences Associated with the Temporal Lobe. CONCLUSIONS: The results are consistent with previous findings linking the factors of inner speech with the propensity to auditory hallucination, a phenomenon widely associated with temporal lobe abnormalities. The hallucinations associated with other perceptual systems, however, are still weakly explained.

Multidimensionalidad del Habla Interna y su relación con las percepciones anómalas / Multidimensionality of inner speech and its relationship with abnormal perceptions

Introducción: Hablar consigo mismo es una experiencia humana habitual. En los últimos años han surgido estudios que asocian esta experiencia con funciones cognitivas como la solución de problemas, la lectura, la escritura, la memoria autobiográfica, y con algunos trastornos como la ansiedad y la depresión. Además se reconoce al habla interna como la principal fuente de las alucinaciones auditivas. Objetivos: El presente estudio tiene como propósito principal establecer la estructura factorial del Varieties of Inner Speech Questionnaire (VISQ) en una muestra de población colombiana. Además buscamos establecer la relación entre el VISQ y la propensión a las percepciones anómalas. Método: Estudio instrumental transversal en el cual participaron 232 estudiantes universitarios quienes respondieron el VISQ y la Escala de Percepciones Anómalas de Cardiff (CAPS). Resultados: A través de un análisis factorial exploratorio se encontró una estructura de tres factores: Otras Personas en el Habla Interna, Habla Interna Condensada y Habla Interna Dialógica/ Evaluativa, con índices aceptables de fiabilidad de las puntuaciones (ordinal entre.75-.86) Se hallaron diferencias entre géneros en el segundo y tercer factor con promedios más altos para las mujeres. Se encontraron correlaciones positivas entre los tres factores del VISQ y los dos factores del CAPS: Alteraciones Perceptuales Multimodales y Experiencias Asociadas al Lóbulo Temporal. Conclusiones: Los resultados son consistentes con hallazgos previos que relacionan los factores del habla interna con la propensión a la alucinación auditiva, fenómeno ampliamente asociado a alteraciones del lóbulo temporal. Las alucinaciones asociadas a otros sistemas perceptivos, sin embargo, son aun débilmente explicadas.

Background: Inner speech is a common human experience. Recently, there have been studies linking this experience with cognitive functions, such as problem solving, reading, writing, autobiographical memory, and some disorders, such as anxiety and depression. In addition, inner speech is recognised as the main source of auditory hallucinations. Objectives: The main purpose of this study is to establish the factor structure of Varieties of Inner Speech Questionnaire (VISQ) in a sample of the Colombian population. Furthermore, it aims at establishing a link between VISQ and abnormal perceptions. Method: This was a cross-sectional study in which 232 college students were assessed using the VISQ and the Cardiff Anomalous Perceptions Scale (CAPS). Results: Through an exploratory factor analysis, a structure of three factors was found: Other Voices in the Internal Speech, Condensed Inner speech, and Dialogical/Evaluative Inner speech, all of them with acceptable levels of reliability. Gender differences were found in the second and third factor, with higher averages for women. Positive correlations were found among the three VISQ and the two CAPS factors: Multimodal Perceptual Alterations and Experiences Associated with the Temporal Lobe. Conclusions: The results are consistent with previous findings linking the factors of inner speech with the propensity to auditory hallucination, a phenomenon widely associated with temporal lobe abnormalities. The hallucinations associated with other perceptual systems, however, are still weakly explained.

[Factorial Structure of the Cardiff Anomalous Perceptions Scale (CAPS) in a Colombian Population Sample]. / Estructura factorial de la Cardiff Anomalous Perceptions Scale (CAPS) en una muestra de población colombiana.

BACKGROUND: The continuum hypothesis of psychosis assumes that hallucinations are not exclusive of psychotic disorders. A number of psychometric tests have been developed to assess psychosis using a dimensional model. OBJECTIVES: To determine the factorial structure of the Cardiff Anomalous Perceptions Scale (CAPS) for the Colombian population, and to contrast the fit of two factor models previously reported in the literature by conducting a confirmatory factor analysis (CFA). METHODS: This was a cross-sectional study in which 207 subjects from the general population were assessed using the Cardiff Anomalous Perceptions Scale. RESULTS: A two-factor structure with acceptable ordinal alpha coefficients (α=.88 and α=.87) was found. One factor gathered items related to multimodal perceptual alterations, and a second factor grouped items related with experiences linked to the temporal lobe. The analysis of the first factor indicated that it was dependent on cultural issues for the interpretation of sensations. The second factor appeared almost unchanged on diverse populations, suggesting its transcultural character. When comparing the models proposed by Bell et al. and Jaen-Moreno et al. using the data obtained from the sample, the confirmatory factor analysis conducted indicated inadequate goodness-of-fit indexes (χ(2)). However, some incremental goodness-of-fit indexes (normalized χ(2) [RMSEA]) were acceptable. The Jaén-Moreno et al. model showed the best fit to the data collected from the Colombian sample. CONCLUSIONS: The factorial structure of CAPS for the Colombian population appears to be sensitive to cultural issues, especially when describing anomalous sensorial experiences.

Estructura factorial de la Cardiff Anomalous Perceptions Scale (CAPS) en una muestra de población colombiana / Factorial Structure of the Cardiff Anomalous Perceptions Scale (CAPS) in a Colombian Population Sample

Introducción: La hipótesis del continuo de la psicosis asume que las alucinaciones no son fenómenos exclusivos de los trastornos del espectro psicótico. Se ha desarrollado una serie de pruebas psicométricas abordando la psicosis a partir de un modelo dimensional. Objetivos: Determinar la estructura factorial de la Escala de Percepciones Anómalas de Cardiff (CAPS) en población colombiana y contrastar el ajuste de dos modelos factoriales previamente reportados en la literatura utilizando la técnica de análisis factorial confirmatorio (AFC). Métodos: Estudio instrumental y transversal en el que participaron 207 sujetos de la población general evaluados con la CAPS. Resultados: Se encontró una estructura de dos factores con coeficientes alfa ordinales aceptables (α = 0,88 y α = 0,87). Un primer factor reúne ítems relacionados con alteraciones perceptuales multimodales y un segundo factor agrupa ítems asociados a experiencias relacionadas con el lóbulo temporal. El análisis del primer factor indica que depende de aspectos culturales en la interpretación de las sensaciones. El segundo factor aparece casi inalterable en diversas poblaciones, lo cual hace pensar en su carácter transcultural. Al comparar los modelos de Bell et al. y Jaén-Moreno et al., a partir de los datos obtenidos, los AFC muestran índices de ajuste absolutos (χ²) inadecuados. Sin embargo, algunos índices de ajuste incremental (χ²normalizado [RMSEA]) son aceptables. De los dos modelos, el propuesto por Jaén-Moreno et al. Fue el que mejor se adecuó a los datos de la muestra colombiana. Conclusiones: La estructura factorial del CAPS en población colombiana parece ser sensible a aspectos culturales en la interpretación de experiencias sensoriales anómalas.

Background: The continuum hypothesis of psychosis assumes that hallucinations are not exclusive of psychotic disorders. A number of psychometric tests have been developed to assess psychosis using a dimensional model. Objectives: To determine the factorial structure of the Cardiff Anomalous Perceptions Scale (CAPS) for the Colombian population, and to contrast the fit of two factor models previously reported in the literature by conducting a confirmatory factor analysis (CFA). Methods: This was a cross-sectional study in which 207 subjects from the general population were assessed using the Cardiff Anomalous Perceptions Scale. Results: A two-factor structure with acceptable ordinal alpha coefficients (α=.88 and α=.87) was found. One factor gathered items related to multimodal perceptual alterations, and a second factor grouped items related with experiences linked to the temporal lobe. The analy sis of the first factor indicated that it was dependent on cultural issues for the interpretation of sensations. The second factor appeared almost unchanged on diverse populations, sug gesting its transcultural character. When comparing the models proposed by Bell et al. and Jaen-Moreno et al. using the data obtained from the sample, the confirmatory factor analysis conducted indicated inadequate goodness-of-fit indexes (χ²). However, some incremental goodness-of-fit indexes (normalized χ² [RMSEA]) were acceptable. The Jaén-Moreno et al. model showed the best fit to the data collected from the Colombian sample. Conclusions: The factorial structure of CAPS for the Colombian population appears to be sensitive to cultural issues, especially when describing anomalous sensorial experiences.