The effect of discrimination on Mental Health in the Chilean Population

Introduction: Discrimination affects the health and well-being of those who experience it. The relationship between discrimination and mental health in migrant communities and in the Chilean child and youth population has been previously studied, however, there is little evidence regarding the effects of discrimination on the general population. Objective: To analyze the relationship between discrimination and the presence of anxious and depressive symptoms in the Chilean population. Methods: Prospective cross-sectional study evaluating 927 subjects in the cities of Arica, Antofagasta, and Santiago. To evaluate discrimination the Krieger Discrimination Experience Scale is used. To asses depressive and anxious symptomatology, the Beck scales for BDI Depression and BAI Anxiety were implemented. Results: The mean age of the sample is 33.9 years (Range 18-70 years; SD=13.13). 59.5% of the participants are female. 36% of the participants reported having experienced discrimination in some aspect of their lives. The highest perception of discrimination is associated with employment (42%) and the main reported causes are level of education or income, age, and gender. Experiences of discrimination exert statistically significant positive effects of moderate magnitude (b>.30) on depressive (b=.460, p<.001) and anxious (b=.480, p<.001) symptomatology, the latter being interrelated (b=.636, p<.001). Conclusions: More than a third of the population studied reported having been discriminated in some aspect of their lives. This perception is further accentuated in relation to employment. The perception of discrimination is associated with an increase in anxious and depressive symptoms in the Chilean population.

Introducción: La discriminación afecta la salud y el bienestar de las personas que la experimentan. Se ha estudiado ampliamente la relación entre discriminación y salud mental en comunidades migrantes y en población infanto-juvenil chilena, sin embargo, existe escasa evidencia respecto a los efectos de esta en la población general. Objetivo: Analizar la relación entre discriminación y la presencia de sintomatología ansiosa y depresiva en población chilena. Material y Método: Estudio transversal prospectivo evaluando 927 sujetos en las ciudades de Arica, Antofagasta y Santiago. Para evaluar discriminación se utiliza la escala de experiencias de discriminación de Krieger. Para evaluar sintomatología depresiva y ansiosa se utilizan las escalas de Beck para Depresión BDI y Ansiedad BAI. Resultados: La edad promedio de la muestra es de 33,9 años (Intervalo de 18 a 70 años; DE=13,13). El 59,5% de los participantes son mujeres. Un 36% de los participantes declara haber experimentado discriminación en algún aspecto de su vida. La mayor percepción de discriminación se asocia al empleo (42%) siendo las principales causas reportadas el nivel educacional o de ingresos, la edad y el sexo. Las experiencias de discriminación ejercen efectos positivos estadísticamente significativos de magnitud moderada (b>.30) sobre sintomatología depresiva (b=.460, p<.001) y ansiosa (b=.480, p<.001) estando las últimas interrelacionadas entre sí (b=.636, p<.001). Conclusión: Más de un tercio de la población estudiada reporta haber sido discriminada en algún aspecto de su vida. Esta percepción se agudiza en torno a la obtención de empleo. La percepción de discriminación se asocia a incremento en sintomatología ansiosa y depresiva en la población chilena.

Necesidad de apoyo psicológico y etnicidad en personas diagnosticadas con Esquizofrenia: La importancia del componente subjetivo en el abordaje del estigma internalizado / Need for psychological support and ethnicity in people diagnosed with Schizophrenia: The importance of the subjective component in addressing internalized stigma

Objetivo Comparar las características socio-demográficas, la calidad de vida, el malestar psicológico y los niveles de estigma internalizado en una muestra de pacientes con Esquizofrenia pertenecientes a la región de Arica y Parinacota que reciben tratamiento en el mismo sistema de salud mental. Método Participaron 209 pacientes con un diagnóstico de Esquizofrenia usuarios de los servicios públicos ambulatorios de salud mental. Resultados La pertenencia a la etnia Aymara no determinó diferencias en las características sociodemográficas. Por otra parte, el grupo de pacientes Aymara presentó mayores niveles de Alienación en la escala de Estigma Internalizado en comparación al grupo de pacientes No-Aymara. La necesidad de apoyo psicológico es convergente a los niveles de malestar psicológico, la calidad de vida y el estigma internalizado. Conclusiones Los hallazgos refuerzan la adecuada capacidad de los usuarios con Esquizofrenia para valorar sus necesidades de apoyo psicológico durante el tratamiento en función de sus niveles de calidad de vida y malestar psicológico.

Objective The aim of this study was to compare the socio-demographic characteristics, quality of life, psychological distress and levels of internalized stigma in a sample of patients with Schizophrenia belonging to the region of Arica and Parinacota who receive treatment in the same mental health system. Methods 209 patients with a diagnosis of schizophrenia, users of public outpatient mental health services, participated in the study. Results Aymara ethnicity did not determine differences in sociodemographic characteristics. On the other hand, the group of Aymara patients had higher levels of Alienation on the Internalized Stigma Scale compared to the group of Non-Aymara patients. Need for psychological support are convergent to levels of psychological distress, quality of life and internalized stigma. Conclusions The findings emphasize the adequate capacity of users with schizophrenia to assess their psychological support needs during treatment based on their levels of quality of life and psychological distress.

Validation of the brief scale for the evaluation of acculturation stress in migrant population (EBEA)

Abstract Background: Acculturation stress is associated with poorer physical and mental health and a lower level of psychological well-being. The causes of acculturation stress are diverse, but most are similar in the migrant population. Despite the importance of evaluating this variable, few studies have reported culturally adapted and validated instruments for specific populations. Based on this, the aim of this study was to evaluate the psychometric properties of a short scale for the evaluation of acculturation stress (EBEA). Methods: Two studies were conducted, involving 1725 first-generation Colombian and Peruvian migrants living in Chile, between the ages of 18 and 60 years. In addition to the EBEA and as evidence of validity, the Beck Anxiety Scale and the WHOQOL-BREF psychological health domain were applied. A confirmatory factor analysis was carried out, and the reliability and nomological validity were evaluated. Results: The results in both studies indicated that the scale presents a factorial structure of three dimensions: (a) the stress derived from the preparation and departure from the country of origin, (b) the stress produced by socioeconomic concerns in the host country, and (c) the tensions typical of adaptation to sociocultural changes or Chilean society. The reliability coefficients and the analysis of their nomological validity were very good. Conclusions: The EBEA is a measure that offers quick, useful screening for researchers who need a short measure for research among migrants. This tool contributes to the work of education, prevention, and intervention in the field of general health and migrants' mental health.

Prevalencia de sintomatología ansiosa y depresiva en migrantes colombianos en Chile

Background: Migratory processes may affect mental health. Data on the health status of migrants are necessary for an adequate public health approach. Aim: To describe the prevalence of anxious and depressive symptoms in Colombian migrants living in Chile and to compare it with the Chilean population. Material and Methods: Beck and BDI scales for depression and BAI anxiety scale were applied to 1,932 participants living in Arica, Antofagasta and Santiago. Of these, 976 participants (51% women) aged 35 ± 10 years were first generation Colombian migrants and 956 participants aged 34 ± 14 years were Chilean. Results: The scores for depressive and anxious symptoms were higher in Chileans than in Colombians. Women reported worse mental health in both groups. Chilean and Colombian respondents residing in Arica and Antofagasta had a higher degree of anxiety and depression than their counterparts residing in Santiago. Conclusions: Chileans have worse mental health indicators than Colombian migrants. There are differences by sex and city of residence.

Salud mental en trabajadores de la salud durante la pandemia por COVID-19 en Chile

Background: COVID-19 has effects on the mental health of health care workers. Aim: To explore the presence of symptoms associated with mental health problems and associated risk factors in health workers. Material and Methods: The questionnaires PHQ-9 for depression, GAD-7 for anxiety, ISI-7 for insomnia and IES-R-22 for psychological distress were applied to 125 health care workers aged 18 to 67 years (32 physicians, 22 nurses and 71 of other professions) laboring in hospitals and primary care facilities along Chile. Results: Sixty five percent reported depression symptoms, 74% anxiety, 65% insomnia and 57% distress. Physicians had lower median scores in all scales than nurses and other health professionals. Professionals attending patients with respiratory infections or with COVID-19 had higher median scores in the scales that their counterparts. Conclusions: The frequency of mental health problems among these professionals is high and preventive measures should be taken.

Problemas de regulación emocional y salud mental en adolescentes del norte de Chile / Emotional regulation problems and mental health in adolescents in northern Chile

Resumen El propósito de este estudio fue evaluar la asociación entre los problemas de regulación emocional e indicadores de salud mental en adolescentes de la ciudad Arica al Norte de Chile, además de describir y comparar los niveles de problemas interiorizados y exteriorizados entre hombres y mujeres. Participaron 2331 estudiantes de 11 a 20 años provenientes de establecimientos educacionales. Para medir los problemas de regulación emocional y los indicadores de salud mental, se utilizó el Sistema de Evaluación de Niños y Adolescentes (SENA). Los resultados muestran que los problemas de regulación emocional poseen efectos grandes y significativos sobre los problemas interiorizados y exteriorizados. Asimismo, se observó que las mujeres presentan mayor sintomatología depresiva, ansiosa, de ansiedad social y problemas de regulación emocional que los hombres. Pareciera ser que los adolescentes que manifiestan problemas para regular sus emociones son más vulnerables a experimentar estados de ánimos disfóricos, preocupaciones recurrentes o comportamientos disruptivos.

Abstract The aim of this study was to assess the relationship between emotional regulation problems and mental health outcomes in adolescents from the city of Arica in northern Chile, in addition to describing and comparing the levels of internalized and externalized problems between men and women. A total of 2331 students from 11 to 20 years old from educational establishments participated in the study. To measure emotional regulation problems and mental health indicators, the System of Evaluation of Children and Adolescents (SENA) was used. The results show that emotional regulation problems have large and significant effects on both internalized and externalized problems. Likewise, it was observed that women show more depressive, anxious, social anxiety and emotional regulation problems than men. It seems that adolescents who manifest problems in regulating their emotions are more vulnerable to experience dysphoric moods, recurrent worries or disruptive behavior.

La Psicología en la prevención y manejo del COVID-19: aportes desde la evidencia inicial / Psychology in the prevention and management of COVID-19: contributions from the initial evidence

Resumen En diciembre de 2019, se informaron casos de neumonía potencialmente mortal en Wuhan, provincia de Hubei, China (COVID-19). Esta enfermedad se ha extendido rápidamente por todo el mundo con miles de casos confirmados y muertes, transformándose en pandemia y desafiado los sistemas de salud pública. No existe aún vacuna ni tratamiento científicamente probado, sin embargo, se ha identificado los comportamientos exactos que pueden evitar el contagio y propagación. El presente artículo sistematiza información disponible inicial sobre psicología y COVID-19. Se discute que gran parte del problema de la enfermedad se puede evitar cambiando los comportamientos de las personas y que la psicología puede ayudar a explicar, prevenir e intervenir para su solución. La psicología cuenta con evidencia científica disponible que explica todos estos fenómenos, evidencia que debe ser puesta en relieve por los mismos actores de las disciplinas a disposición de otras áreas del conocimiento y sobre todo para los tomadores de decisión.

Abstract In December 2019, highly lethal cases of pneumonia were reported in Wuhan, Hubei Province, China (COVID-19). This disease has spread rapidly around the world with thousands of confirmed cases and deaths, becoming a pandemic and challenging public health systems. There is no vaccine or scientifically proven treatment yet, but the exact behaviours that can prevent transmission and spread have been identified. This article systematizes initial available information on psychology and COVID-19. It is discussed that much of the problem of the disease can be avoided by changing people's behaviors and that psychology can help explain, prevent and intervene to solve it. Psychology has scientific evidence available that explains all these phenomena, evidence that should be highlighted by the same actors in the disciplines available to other areas of knowledge and especially for decision makers.

Manifiesto por la Psicología en Chile: A propósito de la revuelta del 18 de Octubre 2019 / Manifesto for Psychology in Chile: On the subject of the revolt of October 18, 2019

Resumen La psicología en tanto práctica profesional y de investigación científica no puede ni debe permanecer aislada de los contextos en los que se desarrolla. Frente a los profundos sentimientos de malestar expresados por el pueblo chileno en movilizaciones sociales desde el 18 de octubre de 2019, que responden directamente a la implementación de un modelo neoliberal desprovisto de justicia social, como psicólogas y psicólogos nos sentimos llamados a levantar los requerimientos mínimos que consideramos que nuestra disciplina debe asumir. Bajo este marco, se presenta un Manifiesto que contempla 22 puntos, construido de manera colaborativa por 13 psicólogas y psicólogos de diversas instituciones que, en una labor colectiva, lo proponen como agenda de trabajo para los próximos meses. Sabiendo que este listado no es definitivo ni exhaustivo, lo ofrecemos a la comunidad como un punto de partida para la deliberación, discusión y debate dentro de Universidades, centros de investigación, sociedades científicas y profesionales y al aparato estatal, de manera de fortalecer el rol de la psicología en la problematización y reducción las inequidades e injusticias, así como en el fomento del bienestar psicosocial.

Abstract Psychology as a professional and scientific practice should and must not remain isolated from the contexts in which it develops. Considering the deep feelings of discomfort expressed by the Chilean people during social mobilizations since October 18th, 2019, in response to the implementation for decades of a neoliberal model devoid of social justice, as psychologists we feel summoned to raise the minimum requirements we think our discipline must assume about that matter. Under these assumptions, a Manifesto is presented. It includes 22 items, which have been elaborated by 13 psychologists from several institutions that, in a collective effort, propose them as an agenda to work on in the next months. Knowing that this list is not definitive or exhaustive, we offer it to the community as a point of departure for deliberation, discussion and debate within universities, research centers, scientific and professional societies, and the state apparatus, in order to strengthen the role of psychology in the problematization and reduction of inequities and injustices, as well as in promoting psychosocial well-being.

Discriminación percibida en escolares migrantes en el Norte de Chile / Perceived discrimination in migrant schoolchildren in Northern Chile

Resumen La migración en Chile ha trascendido enormemente, siendo la educación uno de los principales focos de atención en miras de la transformación. El objetivo de este estudio es describir la discriminación percibida por escolares migrantes de la ciudad de Arica al Norte de Chile, analizando además la relación entre esta última y el estrés por aculturación. Participaron 678 estudiantes de ambos sexos entre Cuarto Básico a Cuarto Medio, entre los 8 y 19 años. Se utilizó la Escala de Discriminación en la Vida Cotidiana (eds) y la Escala de fuentes de estrés por aculturación (feac). Se encontraron diferencias significativas en la discriminación percibida entre escolares migrantes y no migrantes con una puntuación más alta en los migrantes en todas las edades. Se observa también una relación significativa entre discriminación percibida y estrés por aculturación. Se discuten los resultados y sus implicaciones, para el mejoramiento políticas públicas en el ámbito escolar.

Abstract Migration in Chile has transcended enormously, with education being one of the main focuses of attention in the face of transformation. The aim of this study is to describe the perceived discrimination by migrant school students from the city of Arica in the North of Chile, also analyzing the relationship between the latter and acculturation stress. 678 schoolchildren of both sexes participated between the Fourth grade to senior year at High School, with ages between 8 and 19. The Everyday Discrimination Scale (eds) and the Acculturation Stress Source Scale (feac) were used. Significant differences were found in perceived discrimination between migrant and non-migrant schoolchildren with a higher score among migrants at all ages. There is also a significant relationship between perceived discrimination and acculturation stress. The results and their implications are discussed, for the improvement of public policies in the school environment.

Quality of Life in Aymara Patients with Schizophrenia in the Central-Southern Andes / Calidad de vida en pacientes con esquizofrenia de origen Aymara en la zona Centro-Sur de los Andes

Abstract The study aimed to compare the quality of life (QoL) of patients with schizophrenia belonging to the Aymara ethnic group from the Central-Southern Andes, with Non-Aymara patients. This cross-sectional study was conducted in three mental health clinics in Chile, Peru, and Bolivia. The data included sociodemographic, clinical characteristics and the QoL was assessed using the S-QoL18. Comparative analyses explored QoL differences between Aymara and Non-Aymara patients. Two hundred and fifty-three patients participated. Aymara had lower QoL scores compared to Non-Aymara patients, for total Index, family relationships, and sentimental life dimensions. Monthly family incomes and disorder duration were significantly lower for Aymara patients. Our study supported the hypothesis of poor QoL in Aymara patients with schizophrenia, after considering other socio-demographic and clinical variables such as the attitude to medication.

Resumen El objetivo de este estudio consistió en comparar la calidad de vida (CV) de pacientes con esquizofrenia pertenecientes al grupo étnico aymara de los Andes Centro-Sur, con pacientes no Aymara. En este estudio transversal participaron 253 pacientes de tres clínicas de salud mental en Chile, Perú y Bolivia. Se recogieron datos sociodemográficos y características clínicas. La calidad de vida se evaluó utilizando el Cuestionario S-QoL18. Los análisis comparativos exploraron las diferencias de QoL entre los pacientes Aymara y no Aymara. Los participantes de origen Aymara tuvieron puntuaciones de CV más bajos en comparación con los pacientes no Aymara para el Índice total, las relaciones familiares y la dimensión de vida sentimental. Los ingresos familiares mensuales y la duración del trastorno fueron significativamente más bajos en los pacientes Aymara. Nuestro estudio soporta la hipótesis de una peor CV en pacientes aymaras con esquizofrenia.

Mental health and psychological acculturation strategies in Peruvian and Colombian immigrants in northern Chile / Salud mental y estrategias de aculturación en inmigrantes colombianos y peruanos en el norte de Chile

Abstract Using a cross-sectional, non-experimental design, the hypothesis that the mental health state of assessed immigrants differs according to the acculturation strategy used, was tested. To this end, the mean difference in physiological symptoms, social roles and relationships among participants categorized by type of acculturation strategy, i.e. bicultural integration, separation, isolation and assimilation, was evaluated. The sample consisted of 431 Peruvian and Colombian immigrants, residing in the city of Antofagasta, Chile. To evaluate acculturation, the Revised Acculturation Attitudes Scale by Basabe, Zlovina and Paez was used, and for the mental health assessment, the Self-Assessment Questionnaire OQ-45.2 was applied. Findings show that separation was the most commonly used strategy by Colombians, while in the Peruvian population it was assimilation. Similarly, the Colombian population reported a greater presence of symptoms of mental health problems in all dimensions and in the overall scale than the Peruvian population. In the overall sample, the individuals who used assimilation as their acculturation strategy tended to report more symptoms and difficulties in interpersonal relationships. The data provide evidence that the acculturation strategies used result in a greater or lesser presence of psychopathological symptoms.

Resumo Mediante um desenho não experimental de tipo transversal contrastou-se a hipótese de que o estado de saúde mental dos imigrantes avaliados difere segundo a estratégia de aculturação que utilizem. Para isso, avaliou-se a diferença média em sintomatologia, papel social e relações interpessoais entre os participantes agrupados por tipo de estratégia de aculturação (integração ou biculturalidade, separação, isolamento e assimilação) numa amostra de 431 imigrantes peruanos e colombianos residentes na cidade de Antofagasta, Chile. Para avaliar a aculturação utilizou-se a Escala revisada de atitudes com relação à aculturação de Basabe, Zlovina e Páez, e para avaliar a Saúde Mental aplicou-se o questionário de Autoavaliação OQ-45.2. Como resultado verificou-se que a estratégia mais utilizada pelos colombianos foi a separação, e pelos peruanos, a assimilação, além de que os primeiros apresentaram maior presença de sintomas de problemas de saúde mental em todas as dimensões e na escala total, em comparação com a população peruana. Na amostra total, os indivíduos que utilizaram a estratégia assimilação tiveram uma maior presença de sintomatologia e dificuldades nas relações interpessoais. Os dados contribuem com evidência com relação a que as estratégias de aculturação utilizadas incidiriam numa maior ou menor presença de sintomatologia psicopatológica.

Resumen Mediante un diseño no experimental de tipo transversal se contrastó la hipótesis de que el estado de salud mental de los inmigrantes evaluados difiere según la estrategia de aculturación que utilicen. Para esto se evaluó la diferencia de medias en sintomatologia, rol social y relaciones interpersonales entre los participantes agrupados por tipo de estrategia de aculturación (integración o biculturalidad, separación, aislamiento y asimilación) en una muestra de 431 inmigrantes peruanos y colombianos residentes en la ciudad de Antofagasta, Chile. Para evaluar la aculturación se utilizó la Escala revisada de actitudes hacia la aculturación de Basabe, Zlovina y Páez, y para evaluar la Salud Mental se aplicó el cuestionario de Autoevaluación OQ-45.2. Como resultado se encontró que la estrategia más utilizada por los colombianos fue la separación, y por los peruanos, la asimilación, además de que los primeros reportaron mayor presencia de sintomas de problemas de salud mental en todas las dimensiones y en la escala total, en comparación con la población peruana. En la muestra total, los individuos que utilizaron la estrategia asimilación presentaron un mayor reporte de sintomatologia y dificultades en las relaciones interpersonales. Los datos aportan evidencia con respecto a que las estrategias de aculturación utilizadas incidirian en una mayor o menor presencia de sintomatologia psicopatológica.

Efectos secundarios de la medicación antipsicótica y calidad de vida en pacientes con esquizofrenia latinoamericanos / Side effects of antipsychotic medication and quality of life in Latin-American patients with schizophrenia

El estudio describe la relación entre los efectos secundarios a la medicación y la calidad de vida en pacientes con esquizofrenia. La muestra contó con 253 pacientes de los Servicios Públicos de Salud Mental de Bolivia, Perú y Chile quienes fueron evaluados con la Escala Barnes de Acatisia (EBA); la Escala de Simpson-Angus (SAS) y el Cuestionario de Calidad de Vida (SQoL-18). Ambas escalas: EBA (ß=-2,17; p=0,019) y SAS (ß=-1,97; p= 0,034) presentaron una relación significativa con la escala de calidad de vida. Variables sociodemográficas como la edad (ß=-2,17; p= 0,032); la ocupación (ß=-4,12; p= 0,046); el nivel educativo (ß=-7,14; p= 0,005); la etnia (ß=-3,91; p= 0,035) y variables clínicas como severidad del trastorno (PANSS) mostraron también un peso significativo en la calidad de vida (ß=-6,35; p= ≤ 0,01). Al igual que en países desarrollados, los efectos secundarios de los antipsicóticos tienen una influencia en la calidad de vida de los pacientes.

The study describes the relationship between antipsychotic drug side effects and quality of life in a sample of individuals suffering from schizophrenia. The sample included 253 patients' users of different Public Mental Health Services from Bolivia, Peru and Chile who were evaluated with the Barnes Akathisia Rating Scale (BARS), the Simpson-Angus (SAS) and the Schizophrenia Quality of Life short version questionnaire (SQoL-18). A statistical significant correlation was found between quality of life (SQoL-18) and total scores in the BARS (ß=-2,17; p= 0,019) and SAS (ß=-1,97; p= 0,034). Socio-demographic variables, such as age (ß=-2,17; p= 0,032), education (ß=-7,14; p= 0,005), occupation (ß=-4,12; p= 0,046) and ethnicity (ß=-3,91; p= 0,035), were significant predictors of quality of life. Clinical symptoms (PANSS) also contributed significantly to the model (ß=-6,35; p= ≤ 0,01). As in developed countries, the side effects of antipsychotics have an influence on patients' quality of life.

Adherencia a la medicación antipsicótica en pacientes indígenas con esquizofrenia / Adherence to antipsychotic medication in indigenous patients with schizophrenia

Resumen: Introducción: La falta de adherencia a la medicación antipsicótica sigue siendo un problema en el tratamiento de pacientes con esquizofrenia, más aún en población indígena. Objetivo: Evaluar las diferencias en la adherencia farmacológica, medida a través de la actitud hacia los antipsicóticos, entre pacientes aymara y no-aymara con esquizofrenia. Método: La muestra estuvo compuesta por pacientes que recibían tratamiento en los Servicios Públicos de Salud Mental de Bolivia (32.8%), Perú (33.6%) y Chile (33.6%). Se utilizó el Inventario de Actitud hacia la Medicación (DAI-10); la Escala Barnes de Acatisia (EBA) como medida de efectos secundarios y la Escala para el Síndrome Positivo y Negativo de la Esquizofrenia (PANSS) para evaluar la severidad del trastorno. Resultados: Los pacientes aymara presentan una menor adherencia que los pacientes no-aymara, sin embargo, estas diferencias no fueron significativas (t = 1.29; p = 0.19). La severidad del trastorno y la edad mostraron una asociación significativa con la adherencia, observándose que pacientes más jóvenes y con mayor sintomatología presentan una actitud más negativa hacia los fármacos. Discusión y conclusión: Se discute cómo las dinámicas migratorias han promovido la pérdida de tradiciones y costumbres propias de la etnia promoviendo la adopción de estilos de vida nuevos y cada vez más interculturales, e incluso cambiando su concepción de la enfermedad mental. Los profesionales tratantes deben estar conscientes de no aplicar estereotipos en cuanto a la relación etnia-antipsicóticos.

Abstract: Introduction: Non-adherence to antipsychotic medication remains a complex problem in the treatment of schizophrenia patients, especially in indigenous population. Objective: The aim of the study was to assess the differences in drug adherence, measured by the attitude towards the antipsychotics among Aymara and Non-Aymara patients with schizophrenia. Method: The sample consisted of patients receiving treatment in the Mental Health Public Services in Bolivia (32.8%), Peru (33.6%) and Chile (33.6%). We used the Drug Attitude Inventory (DAI-10); the Barnes Akathisia Scale (BAS), as a measure of side effects, and the Positive and Negative Syndrome Scale (PANSS) to assess the severity of the disorder. Results: The findings showed that Aymara patients present less adherence than Non-Aymara people; however, these differences were not significant (t = 1.29; p = 0.19). The severity of the disorder, as well as the age, showed a significant association with adherence, revealing that younger patients and with greater symptoms presented a more negative attitude toward the drugs. Discussion and conclusion: The lack of significant differences between the groups responds to three possible reasons: 1. This sample of indigenous patients is integrated on Mental Health Services that offer a clear biomedical approach where drug therapy is the primary treatment. 2. It is possible that these indigenous patients are changing their conception of mental disorder, and 3. A significant number of families have migrated to urban areas. These migratory dynamics have promoted the loss of traditions and customs of the ethnic group, which gradually adopts new and intercultural lifestyles. Professionals should be warned about applying stereotypes regarding the relationship between ethnicity and antipsychotics.

Is there a Relationship between Trait and State Optimism and the Assessment of quality of Life? / ¿Existe relación entre los optimismos estado y rasgo y la evaluación de la calidad de vida?

Using a non-experimental, transverse, co-relational design, we assess the relationship between optimism and quality of life (QoL) in adults aged between 18 and 65 years. Two questionnaires were administered: WHOQOL-BREF, which assessed QoL, and an instrument that assessed trait-state optimism. A total of 1190 subjects from various public and private high schools, institutions and commercial centers in the city of Antofagasta, Chile participated. The mean sample age was 40.0 years and 50.0% of respondents were male. There is a relationship between QoL and state optimism, with males demonstrating a higher QoL. Differences in optimism were observed only in age groups in which younger persons scored less than older persons. The results obtained indicate that there is a partial relationship between QoL and optimism, with state optimism having a significant effect on QoL.

Usando un diseño no experimental, transversal-correlacional, evaluamos la relación entre el optimismo y la calidad de vida (CV) en adultos de edades comprendidas entre 18 y 65 años. Se administraron dos cuestionarios: WHOQOL-BREF, que evaluaron la CV, y un instrumento que evalúa optimismo rasgo-estado. Participaron un total de 1190 sujetos de diversas escuelas secundarias públicas y privadas, instituciones y centros comerciales en la ciudad de Antofagasta, Chile. La edad media fue de 40.0 años y 50.0% de los encuestados eran varones. Existe una relación entre el CV y el optimismo estado, entre los varones demostrando una mayor CV. Se observaron diferencias en optimismo solo en grupos de edad en los que las personas más jóvenes puntuaron menos que las personas mayores. Los resultados obtenidos indican que existe una relación parcial de CV y optimismo, con el optimismo estado teniendo un efecto significativo en la CV.

Salud mental y estrés por aculturación en inmigrantes sudamericanos en el norte de Chile / Mental health and stress by acculturation in immigrants from South America in northern Chile

Background: Coping with changes brought about by immigration and social circumstances that often characterize this process may cause mental health problems. Aim: To analyze the relationship between acculturation stress and mental health symptoms in South American immigrants residing in Antofagasta, Chile. Material and Methods: The OQ questionnaire, which assesses mental health and the acculturation stress questionnaire from Ruiz, were answered by 431 immigrants (53.8% Colombian and 46.2% Peruvian) aged between 18 and 65 years old. Results: The major source of acculturation stress was distance from origin, followed by difficulties in social relationships and perceived discrimination and rejection. About 50% of respondents had elevated levels of discomfort in their life, with mental health problems derived from their adjustment to social roles and relationships. There was a high correlation between acculturation stress levels and severity of mental health symptoms. Conclusions: Immigrants are exposed to high levels of stress resulting in a negative impact on their mental health.

Calidad de vida percibida en inmigrantes sudamericanos en el norte de Chile / Quality of life in south american immigrants in north Chile

Bajo un diseño transversal se analiza el efecto de variables socio-demográficas, económicas y relaciona-Íes sobre la calidad de vida (CV) en 421 inmigrantes peruanos y colombianos en el norte de Chile. Para evaluar la CV se utilizó el cuestionario WHOQoL-Bref y un cuestionario sociodemográfico. Los resultados muestran que el dominio mejor evaluado en ambas poblaciones fue el físico, en tanto el peor evaluado fue el ambiental. Las variables sociodemográficas que resultaron con mayor predicción en los dominios fueron la edad, nivel de ingresos mensuales, con quien vive y si se encuentra en pareja. Este estudio espera contribuir al desarrollo de políticas migratorias integrales, sobre todo en torno a la CV de las personas que viven el proceso migratorio día a día, a fin de fomentar su bienestar, prevenir problemas de salud, así como fomentar la integración y la adaptación a la nueva cultura.

Under a cross-sectional design, we analyzed the effect of socio-demographic-economic-relational variables on quality of life (QoL) in a sample of 421 Peruvian and Colombian immigrants in northern Chile. To assess the QoL was used the WHOQOL-Bref and a sociodemographic questionnaire. The results show that the best domain assessed in both populations was the physical, while the worst was the environmental domain. Sociodemographic variables that were most predictive in the domains were age, level of monthly income, with whom you live and whether you are a couple. This study hopes to contribute to the development of comprehensive migration policies, especially regarding the QoL of people living daily migration process, to promote their well-being, prevent health problems and to promote the integration and adaptation to the new culture.

¿Afecta la forma de puntuación la estructura factorial del GHQ-12? Estudio exploratorio en estudiantes iberoamericanos / Does the GHQ-12 scoring system affect its factor structure? An exploratory study of Ibero American students / A forma de pontuação do GHQ-12 afeta o fator de estrutura do instrumento? Estudo exploratório sobre estudantes ibero-americanos

El objetivo de este estudio fue evaluar si el sistema de puntuación del Cuestionario de Salud General (GHQ-12) puede alterar la estructura factorial del instrumento. El método utilizado consideró a 1.972 estudiantes universitarios, correspondientes a 9 países iberoamericanos. Se realizó un modelamiento con ecuaciones estructurales para 1, 2, y 3 factores latentes. Dentro de cada tipo de estructura se analizó el mecanismo de puntuación de las preguntas. Los resultados indican que los modelos de 2 y 3 factores presentan mejores indicadores de bondad de ajuste. En relación a los mecanismos de puntuación, el procedimiento 0-1-1-1 para los modelos de 2 y 3 factores presenta mejor ajuste. En conclusión, pareciera existir una relación entre el formato de respuesta y el número de factores identificados en la estructura del instrumento. El modelo que muestra mejor ajuste entre todos es el de 3 factores con formato 0-1-1-1, sin embargo, el formato 0-1-2-3 tiene indicadores aceptables y más estables, siendo un mejor formato para modelos bi y tridimensionales.

This study aimed to evaluate whether the scoring system of the General Health Questionnaire (GHQ-12) alters the instrument’s factor structure. The method considered 1,972 university students from nine Ibero American countries. Modeling was performed with structural equations for 1, 2, and 3 latent factors. The mechanism for scoring the questions was analyzed within each type of structure. The results indicate that models with 2 and 3 factors show better goodness-of-fit. In relation to scoring mechanisms, procedure 0-1-1-1 for models with 2 and 3 factors showed the best fit. In conclusion, there appears to be a relationship between the response format and the number of factors identified in the instrument’s structure. The model with the best fit was 3-factor 0-1-1-1-formatted, but 0-1-2-3 has acceptable and more stable indicators and provides a better format for two- and three-dimensional models.

O objetivo deste estudo foi avaliar se a pontuação do Questionário de Saúde Geral (GHQ-12) pode alterar o fator de estrutura do instrumento. O método utilizado considerou 1.972 universitários correspondentes a nove países ibero-americanos. Realizou-se modelagem com equações estruturais para 1, 2 e 3 fatores latentes. O mecanismo de pontuação das perguntas foi analisado dentro de cada tipo de estrutura. Os resultados indicam que os modelos de 2 e 3 fatores apresentam os melhores indicadores de bondade de ajuste. Em relação aos mecanismos de pontuação, o procedimento 0-1-1-1 para os modelos de 2 e 3 fatores apresenta melhor ajuste. Em conclusão, parece que há uma relação entre o formato de resposta e o número de fatores identificados na estrutura do instrumento. O modelo que apresenta melhor ajuste é o de 3 fatores com formato 0-1-1-1, no entanto, o formato 0-1-2-3 tem indicadores aceitáveis e mais estáveis, sendo mais indicado para modelos bi e tridimensionais.

Análisis preliminares de la versión adaptada en población chilena de la escala de adherencia terapéutica en diabetes mellitus tipo 2 - EATDM-III / Psychometric properties of the diabetes mellitus 2 treatment adherence scale version III (EATDM-III) adapted for Chilean patients

Background: The Diabetes Mellitus 2 treatment adherence scale version III (EATDM-III) was devised in Costa Rica. Its seven factors are family support, community organization and support, physical exercise, medical control, hygiene and self-care and assessment of physical condition. Aim: To assess the psychometric properties of the scale in Chilean patients. Material and Methods: The results of the EATDM-III scale, applied to 274 patients with Diabetes Mellitus 2 aged 59 ± 11 years (59% women), were analyzed. Reliability, item, exploratory and confirmatory factorial analyses were carried out both in the initial and the proposed model. Results: We propose a version of 30 items grouped in six dimensions, improving the fit indices obtained with the original scale. The review of item factor loadings shows that all are appropriate both in magnitude and statistical significance, with values between 0.46 and 0.93. Internal consistency measured by Cronbach s alpha, was 0.85 for the total scale. Conclusions: The adapted EATDM-III scale is reliable and can be used to assess treatment adherence in Chilean patients.

The Influence of Importance in Self-Report of Quality of Life in Chilean Young People / El impacto de la valoración de la importancia en la evaluación de la calidad de vida en adolescentes chilenos

While self-report of overall quality of life has been widely examined, there are no studies that explore the impact of the relative importance people give to the various categories of their quality of life. Therefore, with a quantitative methodology and a co-relational transverse design, we analyze differences in the assessment when the importance given to each category is evaluated. Participants were 530 students from the city of Antofagasta in the North of Chile, aged between 15 and 18 years. They were from subsidized, public secondary schools and private and state universities in the city who were assessed using the KIDSCREEN-27 questionnaire. Results: Differences were found in the assessment of categories when results were analyzed based on gender and age and when incorporating an assessment of importance. Even when the results were not conclusive, there was evidence of a need to incorporate an importance variable when assessing quality of life.

Aunque el autoreporte ha sido ampliamente estudiado en calidad de vida, aún no se cuenta con estudios que permitan explorar el impacto que pudiese tener en la evaluación, la valoración de la importancia que los(as) jóvenes(as) otorgan a cada uno de los dominios que componen su calidad de vida. Por ello, con una metodología cuantitativa y bajo un diseño transversal correlacional, se analizaron las diferencias existentes en la evaluación, cuando en esta es evaluada la importancia que para cada joven tiene la dimensión sobre la que se inquiere. Participaron 530 estudiantes, entre un rango de edad entre los 15 y los 18 años de la ciudad de Antofagasta. Estos provenían de establecimientos públicos y subvencionados de educación secundaria y de universidades privadas y estatales de la ciudad. La evaluación se hizo mediante el cuestionario específico KIDSCREEN-27. Se encontraron diferencias en la evaluación de los dominios al estratificar el análisis por sexo y edad, al incorporar la valoración de la importancia. Aun cuando los resultados no son concluyentes, aportan evidencia a la necesidad de incorporar la variable importancia en la evaluación de la calidad de vida.

Afrontamiento y etnia: estrategias en niños y niñas aymara / Coping and ethnicity: strategies in aymara boys and girls

Menores aymara han experimentado un proceso migratorio importante durante las últimas décadas, sin embargo, se han desarrollado escasos estudios en población infantil perteneciente a esta etnia. El objetivo de esta investigación es evaluar y comparar las estrategias de afrontamiento utilizado por niños y niñas Aymara y no Aymara. La muestra estuvo compuesta por 685 niños/as entre 9 y 15 años de escuelas municipales y colegios particular subvencionados de la ciudad de Arica. Los resultados muestran la inexistencia de diferencias poblacionales entre niños/as aymara y no aymara en relación a los problemas experimentados (pχ2> .05), el uso de estrategias de afrontamiento utilizadas (pt> .05) y la eficacia de estas últimas (pt> .05). Se concluye que los niños/as pertenecientes a la etnia estarían logrando adecuados mecanismos de afrontamiento en contextos urbanos.

Aymara Childrens have experienced significant migration process over the past decades, however, few studies have been developed in children belonging to this ethnic group. In this reserch, the objective is to evaluate and compare the coping strategies used by Aymara and not Aymara Children. The sample consisted of 685 boys / girls aged 9 and 15 years of Municipal Schools and Private Schools Funded by the city of Arica. The results show the absence of differences population between Aymara and not Aymara boys and girls, in relation to problems experienced (pχ2> .05), the use of coping strategies used (pt> .05) and the effectiveness of the latter (pt > .05). We can conclude that children, as belonging to the ethnic group, are achieving adequate coping mechanisms in urban contexts.