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Rev. chil. neuro-psiquiatr ; 51(1): 16-24, mar. 2013. ilus, tab
Article in Spanish | LILACS | ID: lil-677295

ABSTRACT

Objective: To reveal the impact on the global clinical status and post-traumatic symptoms evolution in women in treatment for severe depression in the Hospital of Curicó, who confronted the F-27 earthquake. Methodology: 75 women in treatment for severe depression were evaluated from the first working day after the catastrophe. According to the ICD-10, acute stress (AS) and post-traumatic stress disorder (PTSD) were clinically determined. The routinary use of the Clinical Global Impression scale (CGI) allowed the monitoring of the clinical status before and after the earthquake. The eight-item treatment-outcome post-traumatic stress disorder scale (TOP-8) was applied twice, at the first and sixth months. Results: AS: 58.7 percent, PTSD: 53.3 percent. Significant deterioration in CGI was observed one month post-event (X² = 3.88; p < 0.05) and an ostensible improvement six months later (X² = 4.65; p < 0.04). The post-traumatic symptoms did not improve significantly. More severe CGI immediately after the earthquake was significantly associated to AS (X² = 13.794; p < 0.008) and to the subsequent development of PTSD (X² = 16.437; p < 0.002). More severe CGI after six months was correlated significantly with previous AS (X² = 15.849; p < 0.003), with PTSD (X² = 17.780; p < 0.001) and with records of childhood trauma (X² = 18.431; p<0.01). Conclusions: After a significant clinical deterioration observed immediately post disaster, at six month the CGI improved the CGI, while post-traumatic symptoms did not. There was no increase in suicidal behavior. Records of childhood trauma were associated with significant aggravation of the CGI six months after the earthquake...


Objetivo: Conocer la evolución clínica global y de síntomas postraumáticos en mujeres enfrentadas al terremoto del 27-F que se encontraban en tratamiento por depresión severa en el Hospital de Curicó. Metodología: 75 mujeres en tratamiento por depresión severa fueron evaluadas a contar del primer día hábil post-catástrofe. Conforme a la CIE-10, se determinó clínicamente estrés agudo (EA) durante el primer mes y postraumático (TEPT) a los seis meses. El uso rutinario de la escala de impresión clínica global (CGI) permitió monitorear el estado clínico desde antes del terremoto. La escala de 8 ítems para la evaluación del trastorno de estrés post-traumático (TOP-8) fue aplicada al primer y sexto mes post-desastre. Resultados: Las prevalencias encontradas fueron: EA 58,7 por ciento y TEPT 53,3 por ciento. Se observó deterioro significativo en CGI al primer mes post- evento (X² = 3,88; p = 0,05) y una ostensible mejoría a los seis meses (X² = 4,65; p = 0,04). No mejoraron significativamente los síntomas postraumáticos. Estados más graves inmediatamente después del terremoto se asociaron significativamente a EA (X² = 13,794; p = 0,008) y a desarrollo posterior de TEPT (X² = 16,437; p = 0,002). Estados más graves a los seis meses se correlacionaron significativamente con EA previo (X² = 15,849; p = 0,003), TEPT X² = 17,780; p = 0,001) y antecedentes de trauma infantil (X² = 18,431;p = 0,01). Conclusiones: Luego del agravamiento clínico inicial post-terremoto, a los seis meses no mejoraron significativamente los síntomas postraumáticos de las pacientes, pero mejoró la CGI y no se observó un aumento de conductas suicidas. El antecedente de trauma infantil se asoció a un deterioro significativo de la CGI a los seis meses post-terremoto...


Subject(s)
Humans , Adult , Female , Young Adult , Middle Aged , Earthquakes , Depressive Disorder/epidemiology , Stress Disorders, Post-Traumatic/epidemiology , Chile , Clinical Evolution , Prevalence , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology
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