ABSTRACT
Background: Depression is the most common psychiatric disorder in people with suicidal behavior. The knowledge of its risk factors should help to design preventive strategies. Aim: To describe suicidal behavior and risk factors for attempted suicide in people with major depressive disorders (MDD). Material and Methods: A 12-month follow-up study was conducted in 112 outpatients at three psychiatric care centers of Ñuble, Chile, with baseline and quarterly assessments. Demographic, psychosocial and clinical factors as potential risk factors of suicide attempts, were assessed. A clinical interview with DSM-IV diagnostic criteria checklist, Hamilton Depression Scale and the List of Threatening Experiences and Multidimensional Scale of Perceived Social Support were applied. Results: Sixty seven percent of participants had suicidal ideation and 43.8% had attempted suicide. Suicide risk was significantly higher in participants with a single major depressive episode (odds ratio [OR] = 3.98; 95% confidence intervals [CI] = 1,29-12,32 p = 0.02) and those with previous suicide attempts (OR = 13.15; 95% CI = 3,87-44.7 p < 0.01). Young age, not having a partner, being unemployed, having a severe major depressive episode, having psychotic symptoms, having a personality disorder and being devoid of medical illness increased the risk of suicide attempts, but they did not reach statistical significance. Conclusions: Significant risk factors should be specially considered when designing suicide preventive strategies in patients with MDD.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Suicide, Attempted/psychology , Secondary Care/statistics & numerical data , Depressive Disorder, Major/psychology , Personality Assessment/statistics & numerical data , Psychotic Disorders/psychology , Socioeconomic Factors , Suicide, Attempted/classification , Chile , Risk Factors , Follow-Up Studies , Longitudinal Studies , Age Factors , Marital Status/statistics & numerical data , Diagnostic and Statistical Manual of Mental Disorders , Depressive Disorder, Major/therapy , Suicidal IdeationABSTRACT
Background The knowledge of predictive factors in depression should help to deal with the disease. Aim To assess potential predictors of remission of major depressive disorders (MDD) in secondary care and to propose a predictive model. Material and Methods A 12 month follow-up study was conducted in a sample of 112 outpatients at three psychiatric care centers of Chile, with baseline and quarterly assessments. Demographic, psychosocial, clinical and treatment factors as potential predictors, were assessed. A clinical interview with the checklist of DSM-IV diagnostic criteria, the Hamilton Depression Scale and the List of Threatening Experiences and Multidimensional Scale of Perceived Social Support were applied. Results The number of stressful events, perceived social support, baseline depression scores, melancholic features, time prior to beginning treatment at the secondary level and psychotherapeutic sessions were included in the model as predictors of remission. Sex, age, number of previous depressive episodes, psychiatric comorbidity and medical comorbidity were not significantly related with remission. Conclusions This model allows to predict depression score at six months with 70% of accuracy and the score at 12 months with 72% of accuracy.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Secondary Care/statistics & numerical data , Depressive Disorder, Major/therapy , Outpatients/statistics & numerical data , Psychiatric Status Rating Scales , Psychotherapy/methods , Reference Values , Socioeconomic Factors , Time Factors , Remission Induction , Comorbidity , Chile , Sex Factors , Predictive Value of Tests , Reproducibility of Results , Follow-Up Studies , Longitudinal Studies , Age Factors , Treatment Outcome , Depressive Disorder, Major/diagnosisABSTRACT
Background: Depression is considered the second leading cause of disability worldwide. Aim: To describe the clinical characteristics and the evolution of major depressive disorder (MDD) in secondary care. To evaluate the association between socio-demographic and clinic variables with the first or recurrent major depressive events (MDE). Material and Methods: Clinical features, treatment, remission and duration of MDE were evaluated during a follow up lasting 12 months in 112 participants aged 44 ± 15 years (79% women). Patients were assessed as outpatients every three months at three psychiatric care centers of Chile. Clinical interviews were carried out using DSM-IV diagnostic criteria checklists and the Hamilton Depression Scale was applied. Results: Most patients were referred from primary care. The mean time lapse for referral to the secondary level was 10.8 months. Most patients had episodes that were recurrent, severe, with a high rate of psychosis, with suicide attempts and melancholic features and with psychiatric and medical comorbidities. Remission rate was 27.5%. In only 16 % of patients, the episode lasted six months or less. The group with recurrent episodes had different age, sex and clinical features. Conclusions: MDD treated at the secondary care level is severe and its symptoms are intense. The time lapse prior to referral was prolonged. Primary care management and referral of these patients should be studied more closely.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Depressive Disorder, Major/drug therapy , Antidepressive Agents/therapeutic use , Psychiatric Status Rating Scales , Recurrence , Socioeconomic Factors , Chile , Longitudinal Studies , Treatment Outcome , Depressive Disorder, Major/epidemiology , Ambulatory CareABSTRACT
El suicidio e intento de suicidio (IS) han adquirido relevancia en las últimas décadas, especialmente entre adolescentes. En población infantil, la conducta suicida es una situación poco estudiada. Este trabajo recopila los antecedentes de niños con intento de suicidio en la provincia de Ñuble, Chile, concluyendo que existe un importante número de hospitalizaciones por IS y se destaca como factores de riesgo la presencia de IS previo, abuso físico y / o sexual, patología psiquiátrica previa y disfunción familiar.
Subject(s)
Humans , Male , Adolescent , Female , Child , Suicide, Attempted/statistics & numerical data , Suicide, Attempted/psychology , Age and Sex Distribution , Comorbidity , Chile/epidemiology , Socioeconomic Factors , Mental Disorders/epidemiologyABSTRACT
Con el objeto de conocer características clínicas de los pacientes y la concordancia diagnóstica entre psiquiatras y otros médicos, se efectuó un estudio retrospectivo en un total de 385 interconsultas psiquiátricas en Hospital de Chillán. La mayoría provenía de medicina (48,8 por ciento), eran mujeres (63,6 por ciento) y tenían en promedio 36,4 años, El diagnóstico psiquiátrico más frecuente fue intento de suicidio (24.6 por ciento) y la patología médica más diagnosticada fue intoxicación por medicamentos (22,2 por ciento). Destacó el alto porcentaje de intento de suicidio y el bajo porcentaje de delirium y demencia. Se observó un 49,6 por ciento de acuerdo diagnóstico, alta concordancia en esquizofrenia y otros trastornos psicóticos y baja concordancia en trastornos adaptativos.
Subject(s)
Humans , Male , Adult , Female , Hospitals, General/statistics & numerical data , Psychiatry/statistics & numerical data , Referral and Consultation , Mental Disorders/diagnosis , Chile , Interprofessional Relations , Retrospective Studies , Suicide, AttemptedABSTRACT
Se presentan los resultados de un estudio prospectivo realizado en atención primaria con el objeto de conocer características demográficas y clínicas de 522 pacientes con depresión. La mayoría eran mujeres, con edad entre 25 y 45 años, de escolaridad básica, casada y dueñas de casa. Se observó un bajo reconocimiento de la depresión. El diagnóstico más frecuente fue depresión mayor leve. La indicación significativamente más empleada fue farmacoterapia. Destacan las dosis subterapéuticas de antidepresivos tricíclicos, subderivación al nivel secundario, requerimiento significativo de equipos de salud mental y baja adherencia a control. Se concluye que la mayoría de los pacientes depresivos pueden ser tratados en atención primaria, pero es necesario mejorar: el diagnóstico, indicaciones farmacológicas, psicoterapéuticas, intervenciones psicosociales, derivaciones y estrategias para aumentar la adherencia al tratamiento
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Primary Health Care/statistics & numerical data , Depression/diagnosis , Antidepressive Agents , Depression/epidemiology , Depression/drug therapy , Hospitals, State , Rural Population/statistics & numerical data , Prospective Studies , Refusal to Treat , Socioeconomic FactorsABSTRACT
Se investigó la prevalencia de suicidalidad y su relación con características sociodemográficas, familiares y psicológicas en una muestra conformada por 1.200 adolescentes de enseñanza media de la Comuna de Concepción. Se empleó una encuesta anónima que incluía: cuestionario de suicidalidad, apgar familiar, escala de desesperanza, inventario de depresión y escala de reajuste social. La edad promedio fue de 16,3 años y el 58 por ciento fueron mujeres. La prevalencia de vida de ideación suicida fue de 57,0 por ciento y la de intentos de suicidio fue de 14,2 por ciento. El estudio pone de manifiesto una alta prevalencia de intentos de suicidio en adolescentes y muestra una superposición de niveles de suicidalidad y una persistencia de ésta en el tiempo. Encuentra que el intento de suicidio se asocia con ideación suicida severa. La suicidalidad se asoció significativamente con disfunción familiar, depresión y mayor estrés vital; no así con desesperanza
Subject(s)
Humans , Male , Female , Adolescent , Adolescent Behavior/psychology , Suicide, Attempted/statistics & numerical data , Causality , Depression/psychology , Family Relations , Socioeconomic Factors , Stress, Psychological , Suicide, Attempted/psychologyABSTRACT
Se describen características del intento de suicidio de 171 adolescente, no consultantes. Se empleó una encuesta anónima que incluía un cuestionario de suicidalidad y preguntas abiertas sobre características del intento de suicidio. El 71,9 por ciento eran mujeres y el 28,1 por ciento varones. El 50,9 por ciento había intentado suicidarse en los últimos 12 meses. La mayoría, efectuó un intento, no estuvo hospitalizado y se sintió arrepentido después del intento de suicidio. La ingestión de medicamentos y las lesiones cortantes fueron los métodos más empleados. La alusión a sentimientos o pensamientos de si mismos o frente a la vida y los problemas familiares fueron los motivos más frecuentes del intento de suicidio