ABSTRACT
Introducción: Se ha reconocido que el déficit atencional (DA) persiste en la adultez en un 50-70 por ciento de los casos, sin embargo, existe escasa investigación respecto de prevalencia e impacto en este grupo etáreo. Nos proponemos conocer la prevalencia de DA en estudiantes de medicina chilenos. Metodología: Se utilizó encuesta sociodemográfica, cuestionario de salud mental de Goldbergy escala ASRS v.1.1. Resultados: Un 22,9 por ciento resultó positivo para síntomas mentales, y un 31 por ciento lo fue para DA según ASRS, en contraste con un 7 por ciento de autorreporte de diagnóstico previo de DA. No hubo correlación significativa entre diagnóstico de DA por escala ASRS con sexo, edad ni lugar de procedencia, pero si la hubo con Goldberg positivo, antecedente de diagnóstico psiquiátrico previo y diagnóstico previo de DA. Discusión: La medición de DA probablemente está sesgada por variables emocionales y derivadas de la alta demanda académica y la expectativa de rendimiento de los alumnos. Pensamos que la prevalencia real de DA en estudiantes de medicina debiera estar cercana al 7% reportado por los alumnos y en línea con las publicaciones internacionales. Este es el primer estudio nacional en este tema y obliga a plantear otra modalidad de investigación.
Introduction: It has been recognized that the attention deficit (AD) persists into adulthood in 50-70% of cases, however, there is little research on prevalence and impact on this age group. We propose to determine the prevalence of AD in Chilean medical students. Methods: We used demographic survey, Goldberg mental health questionnaire and ASRS v.1.1. scale. Results: 22.9% were positive for mental symptoms, and 31% was for AD measured with ASRS, compared with 7% of self-reported prior diagnosis of AD. There was no significant correlation between diagnosis of AD by ASRS scale with sex, age and place of origin, but if there was one with positive Goldberg, history of previous psychiatric diagnosis and previous diagnosis of AD. Discussion: The measurement of DA is probably biased by emotional variables derived from the high demand and the expectation of academic achievement of students. We think that the true prevalence of AD in medical students should be close to 7% reported by students and in line with international publications. This is the first Chilean study on this topic and it forces to raise other research modalities.
Subject(s)
Humans , Male , Adult , Female , Young Adult , Students, Medical/psychology , Attention Deficit Disorder with Hyperactivity/epidemiology , Chile , Mental Health , Prevalence , Socioeconomic Factors , Surveys and Questionnaires , Attention Deficit Disorder with Hyperactivity/psychologyABSTRACT
The contribution of Dr. Bruner to psychology and psychiatry is largely unknown. This is a summary of the ideas proposed in his "Medical-Psychological Monograph" from 1857, that was written after a case of a possibly possessed woman from Santiago. In this work Dr. Bruner discards the spirit-brain duality, proposes a functional morphology of the brain, recognizes the importance of remote history taking when interviewing patients, proposes a theory for self-formation and the risks of self-fragmentation. He proposes that the case of the woman corresponds to a brain disease, opposing the thought of an ovarian and uterine origin. He proposes a hypothesis of the psychogenic origin of the disease, the importance of what happened during dreams and beyond the conscience of the patient. Many of his ideas preceded by decades those of Charcot and Freud, but they have not had a proper recognition.
Subject(s)
History, 19th Century , Psychiatry/history , Psychology/history , Chile , Hysteria/historyABSTRACT
Background: Since Internet made its first appearance for the general public, and its thereafter growth, different emerging health issues have been described. The discussion has taken place not only in the mass media, but also in the academy, initially with case reports of abuse and dependence, and now that it has been considered as a new diagnosis in the not yet finished DSM-V, either as another category within the substance abuse, or another one more related to the impulse control disorders. Methods: A systematic review of the published literature about the subject was done using related MESH terms: "Internet", "Behavior, Addictive", "Impulse Control Disorders" e "Impulsive Behavior" between 2006 and march 2012. Results: The prevalence of Internet abuse and dependence has been difficult to determine because of the lack of consensus in the diagnostic criteria. As other psychiatric entities, genetic and psychological risk factors could be involved, as well as it could be associated with other comorbidities such as mood disorders, anxiety disorders, ADHD, alcohol abuse and eating disorders. Neuroimaging studies have shown evidence of neurobiological similarities with the structures involved in substance dependence. Conclusion: For answering many of these queries specific terminology is required, in order to validate new instruments for diagnosis and follow up as well, in order to in the future describe the risk factors, natural history and treatment alternatives for this emerging disease.
Introducción: Junto con la aparición de internet, ha ido cobrando interés problemas de salud emergentes asociados al uso de las nuevas tecnologías. La discusión no sólo se ha dado en los medios de comunicación, sino también a nivel académico. Inicialmente asociado al reporte de casos de "adicción a internet", para luego llegar al punto de incluso considerar su incorporación al futuro DSM-V, ya sea homologando el fenómeno a la adicción a substancias, o como un fenómeno emparentado con los trastornos por control de impulsos. Método: Se realizó una revisión sistemática de la literatura publicada sobre el tema utilizando los términos MESH afines: "Internet", "Behavior, Addictive", "Impulse Control Disorders" e "Impulsive Behavior" que se hubieran indexado desde el 2006 a marzo de 2012. Resultados: La prevalencia del abuso y dependencia a internet ha sido difícil de esclarecer por falta de consenso en los criterios diagnósticos. Tal como en otras entidades psiquiátricas podrían existir predisponentes genéticos y psicológicos así como asociación con comorbilidades tales como trastornos del ánimo, trastornos ansiosos, síndrome de déficit atencional e hiperactividad, abuso de alcohol y trastornos alimentarios. Pareciera haber correlato neurobiológico, demostrado en neuroimágenes, con las conocidas adicciones químicas. En cuanto al tratamiento, al no haber instrumentos para medir la respuesta, aún no existe evidencia de eficacia terapéutica. Conclusión: Para esclarecer muchas de estas dudas aún no resueltas hace falta terminología específica e instrumentos validados para diagnosticar y seguir a estos pacientes, para de esta manera describir sus factores de riesgo, curso natural y alternativas de tratamiento.