Trastornos de la conducta alimentaria: alteraciones cardiovasculares al ingreso y evolución a 3 meses / Female adolescents with eating disordes: cardiac abnormalities

Background: Cardiovascular complications can occur in up to 80% of adolescent patients with eating disorders (ED) and account for 30% of their mortality. Aim: To evaluate cardiovascular complications in adolescents with ED and their evolution after refeeding. Patients and Methods: In adolescents with ED admitted to treatment, we assessed the nutritional status, weight loss prior to consultation, presence of bradycardia (BC, defined as heart rate < 60 bpm), we performed an electrocardiogram (ECG) and an echocardiography and measured thyroid hormones. Results: We studied 53 women aged 16.4 ± 2.3 years. Fifteen had a diagnosis of Anorexia Nervosa (AN), seven of Bulimia (BN), eight a not otherwise specified ED (ED-NOS), four a Binge Eating Disorder (BED), sixteen an Atypical Anorexia (AAN) and three an Atypical Bulimia (ABN). Thirty four percent were malnourished and 3.8% overweight. The most common cardiac problem was BC in 51%. In eight of 26 patients in whom an echocardiogram was done, it was abnormal. Six had a decreased ventricular mass, three a pericardial effusion and three valvular involvement. There was a significant association between bradycardia and malnutrition, weight loss and low free triiodothyronine levels. BC was significantly more common in patients with AN, but it also occurred in half of the patients with AAN and in one of three patients with other types of ED. At follow up, bradycardia significantly improved with refeeding. Conclusions: There is an association between all types of ED and bradycardia, as well as anatomical and functional cardiac anomalies.

Estudio de adaptación y validación transcultural de una escala de satisfacción con la vida para adolescentes / Transcultural adaptation and validation of a satisfaction with life scale for Chilean adolescents

Resumen: Introducción: El estudio del bienestar ha aumentado en las últimas décadas por su importancia en la salud mental de las personas. En ese marco, la evaluación de la satisfacción con la vida (SV) se ha utilizado para conocer el bienestar subjetivo (BS), con énfasis en población adulta. Objetivo: Adaptar y validar lingüística y culturalmente a Chile la "Satisfaction with Life adapted for Children" (SWLS- C) de origen canadiense, para conocer el juicio global del adolescente respecto a su propia vida. Pacientes y Método: Estudio transversal, con adolescentes entre 10 y 18 años, de tres niveles socioe conómicos, en la Región Metropolitana de Chile. Tras un proceso de traducción y retrotraducción, se aplicó la escala en 3 grupos: entrevista cognitiva (n = 23) para evaluar la validez semántica, de contenido, de constructo y confiabilidad del mismo; otro grupo como pretest (n = 24) y el tercero para la validación del test (n = 200). Se realizó análisis factorial y medición de validez convergente y divergente. Resultados: Consistencia interna presentó un alpha de Cronbach de 0,815, con correla ciones ítem-total entre 0,51 y 0,7. La correlación entre ítems varió entre 0,390 y 0,607. En la matriz de componentes principales, todos los ítems cumplieron con un factor mayor a 0,3. Significativa correlación inversa entre SWLS-C y el Inventario de Depresión Infantil (CDI), con un R2 lineal de 0,465. Conclusiones: Escala muestra adecuadas propiedades psicométricas, la validez de constructo, el carácter unidimensional y la necesidad de mantener cada ítem de la versión canadiense. SWLS-C, en la versión chilena, resulta adecuado para ser autoaplicado.

Abstract: Background: In recent years, there has been an increasing interest in the determinants of subjecti ve well-being and happiness. In that context, life satisfaction is one of the measures used to assess subjective well-being, with emphasis in adult population. Objective: Adapt and validate (cultu rally and linguistically) the Canadian "Satisfaction with Life adapted for Children" (SWLS-C) in Chilean adolescents, in order to assess their global judgement about their own lives. Patients and Methods: Cross-sectional study, with adolescents between 10 to 18 years old, of both sexes and three socioeconomic levels in the Metropolitan region of Chile. After a process of translation and back translation, the scale SWLS-C was applied in 3 groups: cognitive interviews (n = 23) to evaluate se mantics, content, reliability and construct validity, a second group was used as pretest (n = 24) and a third for the validation of the test (n = 200). Factor analysis was performed and measurement of convergent and divergent validity. Results: The internal consistency of the scale through Cronbach's alpha was 0.815, with item-total correlations between 0.51 and 0.7. The correlation between scale items varies between 0.390 and 0.607. In the main component analysis, all items met the require ment of a factor greater than 0.3. The inverse correlation between SWLS-C and CDI was significant, with a linear R2 of 0.465. Conclusions: The Chilean version of the SWLS-C shows adequate psycho metric properties, construct validity, confirming its unidimensional character and the need to keep each item of the Canadian version. SWLS-C, in its Chilean version, is suitable to be self-applied in adolescent population. Further studies are needed to provide further evidence.