Violencia escolar y su relación con síntomas ansiosos / Bullying and its association with anxiety symptoms

INTRODUCCIÓN: Violencia escolar es la persecución física o psicológica de un alumno o alumna contra otro, convirtiéndolo en víctima de repetidos ataques. Es un importante marcador de riesgo de conductas antisociales futuras, y se relaciona con mayor prevalencia de síntomas ansiosos. OBJETIVO: Establecer si existe asociación entre la presencia de ansiedad patológica y la práctica de violencia escolar. MATERIAL Y MÉTODOS: Estudio descriptivo observacional y transversal. Se estudió a 166 alumnos de cuarto a octavo básico, de un colegio particular subvencionado de la comuna de Lo Barnechea, en Santiago de Chile. De ellos, 77 fueron hombres y 89 mujeres, entre 9 y 16 años. Se aplicó la escala de Autoreporte de Ansiedad para Niños y Adolescentes (AANA) y el cuestionario de Maltrato entre Iguales por Abuso de Poder (MIAP). Además, se recopilaron datos tales como sexo, edad, número de personas que viven en el hogar y si vive o no con sus padres. RESULTADOS: De los estudiantes evaluados, el 46,99 por ciento clasificó como testigo de violencia escolar, 19,28 por ciento víctima, 10,84 por ciento agresor, 10,84 por ciento víctima-agresor, y un 12,05 por ciento no clasificó en ninguna categoría. Se obtuvo un 36,1 por ciento de prevalencia de ansiedad patológica en el total de individuos; un 41,67 por ciento en agresores y 30,61 por ciento en no agresores, con chi-cuadrado P > 0,05.DISCUSIÓN: La prevalencia de ansiedad patológica en agresores de violencia escolar es mayor que en quienes no la practican; sin embargo, esta asociación no llega a valores estadísticamente significativos.

INTRODUCTION: Bullying is the physical or psychological persecution of one student against another, making him a victim of recurrent attacks. It is one of the most important risk markers for future antisocial behavior, which has also been associated with higher prevalence of anxiety symptoms. OBJECTIVE: Establish if there is an association between pathological anxiety and bullying. METHODS: This is a descriptive, observational and transversal study. 166 students from fourth to eight grades were studied from a semi private school from Lo Barnechea, Santiago, Chile. From this population, 77 were male and89 female, between 9 and 16 years old. The Anxiety Scale for Children and Adolescents (AAA) and the Survey of High School Bullying Abuse of Power questionnaires were applied. Also, data such as sex, age, number of people who are living in their homes and whether they live with their parents or not was collected. RESULTS: From the students evaluated, 46.99 percent classified as bullying witnesses, 19.28 percent as victims, 10.84 percent as aggressors, 10.84 percent aggressor-victim and 12.05 percent didn't classify in any category. A 36.1 percent prevalence of pathologic anxiety was obtained from the totality of individuals. In the aggressor category 41.67 percent had pathological anxiety and 30.61 percent in non-aggressors, with a chi-square P > 0.05. DISCUSSION: Prevalence of pathological anxiety is higher in the aggressor than in the non-aggressor group, however this association is statistically non-significant

Insomnio y respuesta al tratamiento antidepresivo en mujeres consultantes a la atención primaria / The insomnia and the feedback to the antidepressant treatment in primary attention consultant women

Introduction: The insomnia represents a symptom that accompanies several psychiatricdisorders. It is described as a characteristic of the depressive episode, which increases in 40 times the risk to develop a depression. Objective: To establish statistic correlation between the magnitude of the observed insomnia to the moment of the diagnosis of depression and the answer to the antidepressant treatment in the following 3 months of therapy. Methodology: Secondary evaluation of clinical rehearsal randomizado in adult women treated with monitored pharmacotherapy. Sleep global score (PGS), social - demographical and clinical variables were compared, and among them they forward the ones that not in the 3 months of treatment according to blind evaluation with the Hamilton Depression Scale ( HRSD). Results: Sample of 175 women which are in an average age of 37,5 years (IQ 95 percent: 36,4 - 38,5). More than the half married. Most of them were house wives. Two thirds have had episodes of depression at least once. HRDS average of 19,0 (18,8 - 20,3). PGS basal average of 3,0 (d.s.: 1,94). PGS average after the 3 months 0,8 (0,6 - 1,0). Significant statistic correlation was found between the basal PGS and the patients’ recovery (quotient: 0.4106831; p = 0.015). Besides an improvement of 1,2 in the risk of not getting well to the 3 months of treatment (p = 0.05), for each point of PGS. Conclusions: The insomnia corresponds to a pathological entity which can modulate or moderate the apparition of some psychiatric pathologies and constitutes a recovery predictor in the antidepressant treatment, in the third month of treatment.

Introducción: El insomino constituye un síntoma acompañante en diferentes trastornos psiquiátricos. Describiéndose como un marcador de episodio depresivo, que incrementa en 40 veces el riesgo a desarrollar depresión. Objetivo: Establecer correlación estadística entre la magnitud del insomnio observado al momento del diagnóstico de depresión y la respuesta al tratamiento antidepresivo a los 3 meses de terapia. Metodología: Evaluación secundaria de ensayo clínico randomizado en mujeres adultas tratadas con farmacoterapia monitorizada. Se compararon variables de puntaje global de sueño (PGS), sociodemográficas y clínicas entre las que remitieron y las que no a los 3 meses de tratamiento según evaluación ciega con la Escala de Depresión de Hamilton (HRSD). Resultados: Muestra de 175 mujeres con edad promedio de 37,5 años (CI 95 por ciento: 36,4 - 38,5). Más de la mitad casadas. La mayoría dueña de casa. Dos tercios con episodio previo de depresión. HRDS promedio 19,0 (18,8 - 20,3). PGS basal promedio 3,0 (d.s.: 1,94). PGS promedio a los 3 meses 0,8 (0,6 - 1,0). Se encontró correlación estadísticamente significativa entre el PGS basal y la recuperación de las pacientes (coef: 0.4106831; p = 0,015). Además de un incremento de 1,2 en el riesgo de no recuperarse a los 3 meses de tratamiento (p = 0,05), por cada punto del PGS. Conclusiones: El insomnio corresponde a una entidad patológica que pudiera modular o moderar la aparición de algunas patologías psiquiátricas y constituye un predictor de recuperabilidad en el tratamiento antidepresivo, ya a los 3 meses de tratamiento.

Hacia un modelo explicativo biopsicosocial de la relación entre depresión materna y psicopatología infantil / Towards an explanatory biopsychosocial model of the relation between maternal depression and childhood psychopathology

Este artículo describe los resultados de múltiples estudios de la relación entre la depresión materna y los problemas emocionales y conductuales en sus niños y presenta un modelo biopsicosocial de influencias mutuas. Las implicaciones prácticas de este modelo y líneas de investigaciones son discutidas.

This article presents a review of the relation-ship between maternal depression and emotional and conduct problems in their offspring, and also describes a mutual influences biopsychosocial model. Practical implications of this model and potential future researches are discussed.

¿Cómo es la salud mental de los hijos de madres deprimidas consultantes a servicios de atención primaria? / Psychopathology and social functioning among offspring of depressed women

Background: Offspring of depressive parents have two times more risk of developing a depression, other psychiatric diseases or a poor social functioning. Aim: To assess psychopathology and social functioning among offspring of currently depressed mothers. Material and methods: We enrolled 290 depressed mother-child pairs in five primary-care clinics in Santiago. A two-stage screening process to identify female primary-care patients with current major depressive illness with children aged 6-16 years, was used. AH eligible and consenting patients were asked to complete the general health questionnaire (GHQ-12). Those scoring 5 or more were invited to participate in a baseline assessment. The final sample consisted of 290 mother-child pairs. Patients with a current DSM-IV diagnosis of major depression were eligible unless they had current psychotic symptoms, imminent suicide risk, history of mania, or current alcohol abuse. Child psychopathology was assessed with the Child Behavior Checklist (CBCL), a highly reliable and widely used parent-rated checklist to assess competencies and behavioural and emotional problems in children 4 to 18 years of age. Results: Fifty percent (95 percent confidence interval (CI): 43.9-55.7) of children had overall CBCL psychopathology scores in clinical range. Internalizing symptoms were more prevalent than externalizing symptoms (62.2 percent [9596CI: 56.3-67.8] and 35.7 percent [9596CI: 30.2-41.5]. Conclusions: A large proportion of children of depressed poor mothers attending primary care clinics in Chile, had psychopathological symptom scores in the clinical range, with a predominance of internalizing symptoms. These results are similar to those previously reported in the United States of America.

Calidad de vida de mujeres deprimidas en el posparto / Quality of life of women depressed in the post-partum period

Background: Depression is common among women, specially during breeding. Aim: To characterize post-partum depression in a group of women attending a primary health care clinic and its relationship to quality of life. Material and methods: The sample included women meeting criteria for Major Depression, with a child of up to 11 months old. Exclusion criteria included the presence of psychosis, history of mania, alcohol abuse, illegal drug use, high suicide risk, and receiving mental health care in the last three months. Structured interviews used were the Edinburgh postpartum depression scale (EPDS), Mini International Neuropsychiatric Interview (MINI), Medical Outcomes Study Questionnaire (SF-36) and questions about incapacity and health care use. Results: The sample included 159 women with a median age of 27 years (range: 16-43 years). Thirty three percent were married, 30.8% lived in common law marriage, 9.4% were divorced, and 26.4% were single. Most (89.3%) were housewives, 31% were students, and 6.9% were employed. The average score on the EPDS was 17 points (S.D. 4.2). The average SF-36 somatic score was 42.7 points (S.D. 8.2), and the emotional score was 30.3 (D.S. 0.3). The relation between the average score on the EPDS and the somatic and emotional scores was statistically significant (p=0.000-0.006). Conclusions: Most women were mildly to moderately depressed. Their depression was associated with a marked impairment of activities of daily living. These findings add to the evidence suggesting that depression is associated with marked disability cultures, even when the depression is mild to moderate.