Prevalência de transtornos psiquiátricos de pessoas em situação de rua em um grande centro urbano no Brasil / Prevalence of psychiatric disorders in homeless people in a large urban center in Brazil / Prevalencia de trastornos psiquiátricos en personas sin hogar en un gran centro urbano de Brasil

Introdução: O presente estudo visa descrever as condições de saúde mental mais prevalentes na população de rua em um grande centro urbano brasileiro. Objetivo: Descrever as condições de saúde mental mais prevalentes na população de moradores de rua em um grande centro urbano brasileiro. Métodos: Este é um estudo transversal realizado nas regiões centrais e periferias da cidade de São Paulo (SP), Brasil. Para a descrição dos transtornos psiquiátricos utilizamos o Patient Health Questionnaire-9 (PHQ-9) para sintomas depressivos, item 9 do Inventário de Depressão de Beck para ideação suicida, pergunta autorreferida para uso de álcool e drogas ilícitas e item 3 do PHQ-9 para qualidade do sono. Resultados: A média de idade dos participantes foi de 44,54 (desvio padrão ­ DP=12,63) anos, e a maioria era do sexo masculino (n=342; 75%). Quanto à frequência de transtornos psiquiátricos identificados, 49,6% (n=226) dos participantes apresentaram sintomas depressivos, 29,8% (n=136) exibiram ideação suicida, 55,7% (n=254) informaram uso de álcool semanalmente, 34,2% (n=156) informaram usar drogas ilícitas semanalmente e 62,3% (n=284) tinham problemas com sono. Conclusões: A prevalência de condições que afetam a saúde mental entre os participantes é alta. Estes resultados poderão auxiliar profissionais de saúde na elaboração de estratégias de prevenção e tratamento nessa população, pouco estudada.

Introduction: The present study aims to describe the most prevalent mental health conditions in the homeless population in a large Brazilian urban center. Objective: To describe the most prevalent mental health conditions in the population of homeless people in a large Brazilian urban center. Methods: This is a cross-sectional study carried out in the central and periphery regions of São Paulo, state of São Paulo, Brazil. For the description of psychiatric disorders, the following instruments were used: Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, item 9 of the Beck Depression Inventory for suicidal ideation, the self-reported question for the use of alcohol and illicit drugs, and item 3 of the PHQ-9 for sleep quality. Results: The mean age of participants was 44.54 (Standard Deviation=12.63) years, and most were men (n=342; 75%). Regarding the frequency of the identified psychiatric disorders, 49.6% (n=226) of the participants had depressive symptoms, 29.8% (n=136) had suicidal ideation, 55.7% (n=254) reported weekly alcohol use, 34.2% (n=156) reported using illicit drugs weekly, and 62.3% (n=284) had sleep problems. Conclusions: The prevalence of conditions that affect mental health among participants is high. These results may help health professionals to develop prevention and treatment strategies for this understudied population.

Introducción: El presente estudio tiene como objetivo describir las condiciones de salud mental más prevalentes en la población sin hogar en un gran centro urbano brasileño. Objetivo: Describir las condiciones de salud mental más prevalentes en la población de personas sin hogar en un gran centro urbano brasileño. Métodos: Se trata de un estudio transversal realizado en las regiones central y periférica de São Paulo, SP, Brasil. Para la descripción de los trastornos psiquiátricos se utilizó el Cuestionario de Salud del Paciente - 9 (PHQ-9) para síntomas depresivos, el ítem 9 del Inventario de Depresión de Beck para ideación suicida, la pregunta autorreportada para uso de alcohol y drogas ilícitas y ítem 3 del PHQ-9 para la calidad del sueño. Resultados: La edad media de los participantes fue de 44,54 (DE=12,63) años, y la mayoría eran hombres (n=342; 75%). En cuanto a la frecuencia de los trastornos psiquiátricos identificados, el 49,6% (n=226) de los participantes presentaba síntomas depresivos, el 29,8% (n=136) tenía ideación suicida, el 55,7% (n=254) refería consumo semanal de alcohol, el 34,2% (n=156) refirió consumir drogas ilícitas semanalmente y el 62,3% (n=284) presentaba problemas de sueño. Conclusiones: La prevalencia de condiciones que afectan la salud mental entre los participantes es alta. Estos resultados pueden ayudar a los profesionales de la salud a desarrollar estrategias de prevención y tratamiento para esta población poco estudiada.

Avaliação psicológica em cirurgia plástica pósbariátrica: Uma revisão de escopo / Psychological assessment in post-bariatric plastic surgery: A scoping review

Introdução: A obesidade pode acarretar consequências físicas, psicológicas e sociais. A cirurgia bariátrica tem o potencial de melhorar a condição biopsicossocial do paciente. No entanto, o excesso de pele após uma perda de peso rápida e significativa pode causar sofrimento psicológico. A cirurgia plástica, como o único procedimento capaz de remover o excesso de pele, tem o potencial de aperfeiçoar a autoimagem. Além disso, ela pode incentivar o controle do peso. Este estudo investigou, por meio de uma revisão de escopo, se a avaliação psicológica básica, realizada durante a triagem pelo cirurgião plástico, é capaz de identificar o sofrimento psicológico em pacientes que desejam se submeter a cirurgia plástica após a bariátrica. Método: Foi realizado um levantamento bibliográfico, abrangendo artigos publicados entre 2013 e 2023, nos idiomas português, inglês e espanhol, nas Bases de dados MEDLINE, Biblioteca Virtual em Saúde (BVS) e Embase. Resultados: Na estratégia de busca, 48 artigos atenderam os critérios de inclusão e 18 artigos foram mencionados neste estudo. Conclusão: A avaliação psicológica realizada na triagem do cirurgião plástico permite identificar o sofrimento decorrente do excesso de pele pós-cirurgia bariátrica e o sofrimento psicológico prévio. Isso facilita a decisão médica sobre encaminhar ou não o paciente para avaliação psicológica especializada. Essa abordagem amplia a compreensão do paciente sobre a relação entre corpo e mente.

Introduction: Obesity can have physical, psychological, and social consequences. Bariatric surgery has the potential to improve the patient's biopsychosocial condition. However, excess skin after rapid and significant weight loss can cause psychological distress. Plastic surgery, as the only procedure capable of removing excess skin, has the potential to improve self-image. Additionally, it can encourage weight control. This study investigated, through a scoping review, whether the basic psychological assessment, carried out during screening by the plastic surgeon, is capable of identifying psychological distress in patients who wish to undergo plastic surgery after bariatric surgery. Method: A bibliographic survey was carried out, covering articles published between 2013 and 2023, in Portuguese, English, and Spanish, in the MEDLINE, Virtual Health Library (VHL), and Embase databases. Results: In the search strategy, 48 articles met the inclusion criteria, and 18 articles were mentioned in this study. Conclusion: The psychological assessment carried out during plastic surgeon screening allows the identification of suffering resulting from excess skin after bariatric surgery and previous psychological suffering. This facilitates the medical decision about whether or not to refer the patient for specialized psychological evaluation. This approach broadens the patient's understanding of the relationship between body and mind.

Common mental disorders among patients with diabetes in a secondary care facility: nature, prevalence, and explanatory models

Background: Diabetes is a chronic medical condition which is psychologically and behaviourally demanding in nature. Persons with diabetes may be particularly vulnerable to developing mental health disorders. This study was conducted to estimate the prevalence and factors associated with common mental disorders (CMDs) in patients with diabetes and understand their explanatory models of illness. Methods: One hundred and seventy patients who attended the diabetic clinic at a secondary care hospital were recruited to participate in this cross-sectional study. Psychiatric morbidity and the individual's conceptualization of the illness were assessed using the clinical interview schedule-revised and the modified short explanatory model interview (SEMI) respectively. Socio-demographic and clinical details were recorded using a structured proforma. Results: CMDs were observed in 14.7% of the sample and were significantly associated with female gender, longer duration of diabetic illness and treatment, use of insulin and past treatment for psychiatric illness. Illness attributions included unhealthy diet, heredity, and stress, as well as punishment from God. Religious and traditional healing methods were cited as potential sources of help in addition to medical interventions and lifestyle modification. Conclusions: Diabetes can significantly impact the emotional health of an individual in addition to its myriad physical consequences. Understanding patient perspectives regarding their illness and identifying and providing appropriate interventions for those with emotional disorders are an important component of diabetes care programs.

Factors related to mental health problems in nursing students: a multicenter study

Introduction: The COVID-19 pandemic has brought consequences to the mental health of the undergraduate population of nursing programs. Objective: To identify the factors associated with mental health disturbances among university students in nursing programs during the COVID-19 pandemic. Materials and Methods: A multicenter, cross-sectional study was conducted during the COVID-19 pandemic among students enrolled in nursing programs at two Colombian universities and one Spanish university. An online sociodemographic, economic, and personal survey was administered along with the GHQ-12, the Family APGAR, the MOS Social Support Survey, and the IES-R for posttraumatic stress. The prevalence of mental health disturbances and their differences according to the characteristics of the students were estimated; prevalence ratios were also obtained. Results: Of the 302 students, a prevalence of clinically significant mental was found in 61.92%, family dysfunction in 61.58%, and low social support in 9.33%. In addition, 44.46% had posttraumatic stress symptoms, 52.65% had economic difficulties, 54.61% had academic difficulties, and 69.87% had personal difficulties. These mental disturbances were frequent in the presence of moderate family dysfunction (PR=1.77 CI95%=1.15;2.73), difficulty in paying for food (PR=1.35 CI95%=1.09;1.67), a breakup with a partner (PR=1.27 CI95%=1.02;1.59) and clinically relevant posttraumatic stress symptoms (PR=1.69 CI95%=1.28;2.24). Discussion: Psychological distress and its related factors found in nursing students agree with other findings in the literature. Conclusion: A significant proportion of nursing students were affected in their mental health during the pandemic, demonstrating the need for systematic, continuous, and comprehensive strategies by educational institutions.

Introducción: La pandemia de COVID-19 ha traído consecuencias en la salud mental de la población universitaria de enfermería. Objetivo: Identificar los factores relacionados con las alteraciones en la salud mental de universitarios de los programas de enfermería durante la pandemia por COVID-19. Materiales y Métodos: Estudio transversal multicéntrico, en estudiantes de enfermería de dos universidades colombianas y una española durante la pandemia por COVID-19. Se aplicó una encuesta por internet sobre aspectos sociodemográficos, económicos y personales, junto con los cuestionarios de salud mental GHQ-12, APGAR familiar, apoyo social MOS y estrés postraumático IES-R. Se estimó la prevalencia de alteraciones de la salud mental y sus diferencias según las características de los estudiantes, también se obtuvieron razones de prevalencia. Resultados: En 302 estudiantes se encontró una prevalencia de alteraciones mentales de importancia clínica de 61,92%, de disfunción familiar en 61,58%, con bajo apoyo social en 9,33%; además, presentaron síntomas de estrés postraumático (44,46%), sufrieron dificultades económicas (52,65%), académicas (54,61%) y personales (69,87%). Adicionalmente, estas alteraciones fueron más prevalentes ante una disfuncionalidad familiar moderada (RP=1,77 IC95%=1,15;2,73), ante la dificultad para pagar alimentos (RP=1,35 IC95%=1,09;1,67), la pérdida de la pareja (RP=1,27 IC95%=1,02;1,59) y ante síntomas de estrés postraumático (RP=1,69 IC95%=1,28;2,24). Discusión: El sufrimiento psicológico y sus factores relacionados encontrados en los estudiantes de enfermería concuerdan con otros hallazgos en la literatura. Conclusión: Una importante proporción de estudiantes de enfermería estuvieron afectados en su salud mental durante la pandemia, mostrando una necesidad de estrategias sistemáticas, continuas e integrales por parte de las instituciones formativas.

Introdução: A pandemia de COVID-19 trouxe consequências para a saúde mental da população universitária de enfermagem. Objetivo: Identificar os fatores relacionados às alterações na saúde mental de estudantes universitários dos cursos de enfermagem durante a pandemia de COVID-19. Materiais e Métodos: Estudo transversal multicêntrico em estudantes de enfermagem de duas universidades colombianas e uma espanhola durante a pandemia de COVID-19. Foi aplicado um inquérito online sobre aspectos sociodemográficos, económicos e pessoais, juntamente com os questionários GHQ-12 de saúde mental, APGAR familiar, MOS de apoio social e IES-R de stress pós-traumático. Também foram estimadas as prevalências de transtornos de saúde mental e suas diferenças de acordo com as características dos estudantes. Resultados: Em 302 estudantes foi encontrada uma prevalência de transtornos mentais clinicamente importantes de 61,92%, de disfunção familiar em 61,58%, com baixo apoio social em 9,33%; além disso, apresentaram sintomas de estresse pós-traumático (44,46%), sofreram dificuldades econômicas (52,65%), acadêmicas (54,61%) e pessoais (69,87%). Além disso, essas alterações foram mais prevalentes diante da disfunção familiar moderada (RP=1,77 IC 95%=1,15;2,73), diante da dificuldade para pagar a alimentação (RP=1,35 IC 95%=1,09;1,67), a perda do companheiro (RP=1,27 IC 95%=1,02;1,59) e sintomas de estresse pós-traumático (RP=1,69 IC 95%=1,28;2,24). Discussão: O sofrimento psíquico e seus fatores relacionados encontrados em estudantes de enfermagem concordam com outros achados da literatura. Conclusão: Uma proporção significativa de estudantes de enfermagem foi afetada em sua saúde mental durante a pandemia, mostrando a necessidade de estratégias sistemáticas, contínuas e abrangentes por parte das instituições formadoras.

Alteraciones psiquiátricas en pacientes con antecedentes de infección por SARS-CoV-2 / Psychiatric alterations in patients with a history of SARS-CoV-2 infection

Objetivo: Caracterizar los trastornos mentales de los pacientes consultantes del Servicio de Psiquiatría del Hospital Universitario de Caracas enero 2020 ­enero 2021, que acudieron por primera vez y habían presentado infección por COVID-19 3 a 6 meses antes de consultar. Métodos: Se realizó un estudio observacional, descriptivo, retrospectivo, de corte transversal en pacientes que acudieron al Servicio de Psiquiatría del Hospital Universitario de Caracas para emergencia (por primera vez y sucesivas) por presentar patologías mentales durante y posterior a infección por COVID-19 durante el periodo enero 2020-enero 2021. Resultados: De 718 pacientes, 53 que acudieron con patologías mentales habían presentado infección previa por COVID-19 representando el 7,38%. Edad promedio 27-29 años (66,03 %). La mayoría del sexo femenino (71,69 %). El 77,35 % provenían del Distrito Capital; el 18,86 % del estado Miranda, siendo el estado civil predominante la soltería con 73,58 %; el 56,60 % estaban desempleados y el 79,24 % no poseían nivel de instrucción. En relación a los diagnósticos: trastorno depresivo mayor con síntomas ansiosos (30,18 %), trastorno depresivo (18,86 %), episodio maniforme (1,88 %) episodio psicótico agudo (18,86 %), trastorno de ansiedad generalizada (7,54 %), entre otros. Conclusión: Los síntomas psiquiátricos originados por infección por COVID-19 aparecen de forma más tardía y persisten después de la infección. Las mujeres manifestaron mayor riesgo de presentar síntomas relacionados con la salud mental; se asocia a alto nivel de vulnerabilidad a causa de la influencia de los roles sociales, ciclo reproductivo y mayor morbilidad psiquiátrica(AU)

Objective: To characterize the mental disorders of the consulting patients of the Psychiatry Service of the University Hospital of Caracas January 2020 -January 2021, who came for the first time and hapresented COVID-19 infection 3 to 6 monthsbefore consulting. Methods: An observational, descriptive, retrospective, cross-sectional study was carried out in patients who attended the Psychiatry Service of the University Hospital of Caracas for emergencies (for the first time and successive ones) due to presenting mental pathologies during and after COVID-19 during the period January 2020-January 2021. Results: Of 718 patients, 53 who came with mental pathologies had previous COVID-19 infection, representing 7.38%. Average age 27-29 years(66.03%). The majority were female (71.69%). 77.35% came from the Capital District; 18.86% from the state of Miranda, with the predominant marital status being single with 73.58%; 56.60% were unemployed and 79.24% had no educational level. In relation to the diagnoses: major depressive disorder with anxious symptoms (30.18%), depressive disorder (18.86%), maniform episode (1.88%), acute psychotic episode (18.86%), generalized anxiety disorder (7.54%), among others. Conclusion: Psychiatric symptoms caused by COVID-19 infection appear later and persist after infection. Women expressed a greater risk of presenting symptoms related to mental health; It is associated with a high level of vulnerability due to the influence of social roles, reproductive cycle and greater psychiatric morbidit(AU)

Neuropsychiatric symptoms of post-COVID-19 condition in Mexican healthcare personnel / Síntomas neuropsiquiátricos post-COVID-19 en trabajadores de salud mexicanos

Abstract Objective: The aim of the present study was to identify anxiety and depression in health personnel who suffered COVID-19, and to associate them with blood inflammatory markers. Materials and methods: The design of this study was descriptive and cross-sectional. We evaluated 51 healthcare workers who survived COVID-19 disease with Hamilton scales for anxiety and depression, also we calculated inflammatory markers (systemic immune-inflammation index, SII; monocyte lymphocyte ratio, MLR; platelet lymphocyte ratio, PLR; and neutrophil lymphocyte ratio, NLR) using blood venous samples. This study was carried out from August 2021 to December 2022. Statistical analysis was performed using SPSS v. 26. Results: Our study included 51 healthcare personnel, females (n=29) and males (n=22). The mean age was 40.54 ± 11.00 years. The most frequent acute symptoms for COVID-19 presented were dysgeusia (n=20), anosmia (n=18), and headache (n=17). The most common comorbidities were overweight (n=24), obesity (n=22), and hypertension (n=11). According to the Hamilton Rating Scale for Anxiety (HARS) and Hamilton Rating Scale for Depression Rating (HRSD) we identify anxiety and depression in 72.5% (n=37) and 51% (n=26) within the health personnel, respectively. Conclusions: In our study, we observed a high frequency of anxiety and depression in healthcare workers with post COVID-19 condition. However, we did not observe an association between inflammatory markers (NLR, PLR, MLR, and SII) with anxiety and depression in health personnel postCOVID-19. We suggest follow-up assessments in healthcare personnel with post-COVID-19 condition, to evaluate if mixed emotional disorders persist.

Resumen Objetivo: Identificar ansiedad y depresión en el personal de salud que padeció COVID-19, y asociarlos con niveles de marcadores inflamatorios en sangre. Materiales y métodos: El estudio fue descriptivo y transversal. Evaluamos a 51 trabajadores del área de la salud con antecedente de COVID-19, se aplicó las escalas de ansiedad y depresión de Hamilton, y calculamos marcadores inflamatorios (índice de inmunidad/inflamación sistémica, índice monocito/linfocito, índice plaqueta/linfocito, índice neutrófilo/ linfocito) obtenidas de muestras de sangre venosa. El estudio se realizó durante el periodo de agosto del 2021 a diciembre del 2022. El análisis estadístico fue realizado en SPSS v. 26. Resultados: Nuestro estudio incluyó a 51 personas del área de salud, 29 mujeres y 22 hombres. La edad media fue 40.54 ± 11.00 años. Los síntomas agudos más frecuentes que presentaron los trabajadores fueron disgeusia (n=20), anosmia (n=18), y cefalea (n=17). Las comorbilidades más frecuentes fueron: sobrepeso (n= 24), obesidad (n=22), e hipertensión (n=11). Aplicando la Escala de Ansiedad de Hamilton y la Escala de Depresión de Hamilton, identificamos ansiedad y depresión en el personal de salud en 72.5% (n=37) y 51% (n=26), respectivamente. Conclusiones: En nuestro estudio observamos una alta frecuencia de ansiedad y depresión post COVID-19 en el personal de salud. No observamos asociación entre ansiedad, depresión y marcadores inflamatorios hematológicos en los trabajadores de salud en población mexicana que padeció COVID-19. Sugerimos realizar evaluaciones de seguimiento en el personal de salud en condición post COVID-19 para demostrar la persistencia de trastornos mixtos de las emociones.

Salud mental en estudiantes de medicina: un reto más allá del estrés académico / Mental health in medical students: a challenge beyond academic stress

Resumen El proceso de enseñanza en medicina tiene desafíos que pueden inducir estrés académico y con ello afectaciones a la salud mental, por lo que es imprescindible el cuidado de la salud mental de los futuros médicos. Este estudio quiso identificar los factores asociados a la salud mental de estudiantes de medicina de una universidad privada en Colombia, ajustados por estrés académico. Mediante un diseño transversal, se reclutaron 443 estudiantes (68.4% mujeres, 31.6% hombres) quienes completaron un cuestionario con variables sociodemográficas, académicas, el Inventario Cognitivo Sistémico para el Estudio del Estrés Académico y el inventario Symptom Checklist-90-Revised. Los factores de riesgo se analizaron utilizando un Modelo Lineal Generalizado por la familia de Poisson y log link. El 38,3% de los estudiantes presentó un nivel de riesgo en salud mental. Los factores protectores incluyeron actividad física regular (RPa = 0.78) y actividades extracurriculares (RPa = 0.75), mientras que los factores de riesgo fueron uso de sustancias psicoactivas (RPa = 1.36), bebidas energéticas (RPa = 1.35) y tener una ocupación alternativa al estudio (RPa = 1.47). La salud mental de los estudiantes de medicina presenta riesgos más allá de la misma exigencia académica. Hay elementos del individuo y la institución formadora que pueden actuar como factores protectores, lo que se convierte en un insumo para la creación de programas de cuidado y mantenimiento de la salud mental.

Abstract The teaching process in medicine has challenges that can induce academic stress and thus affect mental health, so it is essential to take care of the mental health of future physicians. This study aimed to identify the factors associated with the mental health of medical students at a private university in Colombia, adjusted for academic stress. Using a cross-sectional design, 443 students were recruited (68.4% women, 31.6% men) who completed a questionnaire with sociodemographic and academic variables, the Systemic Cognitive Inventory for the Study of Academic Stress and the Symptom Checklist-90-Revised inventory. Risk factors were analyzed using a Generalized Linear Model by Poisson family and log link. Thirty-eight point three percent of the students presented a level of mental health risk. Protective factors included regular physical activity (RPa = 0.78) and extracurricular activities (RPa = 0.75), while risk factors were psychoactive substance use (RPa = 1.36), energy drinks (RPa = 1.35) and having an alternative occupation to studying (RPa = 1.47). The study provided information on the need for intervention in factors beyond academic stress, seeking to maintain the well-being of students and thus avoid academic dropout.

Determinantes sociales, síntomas y problemas mentales en población adulta víctima de desplazamiento forzado por conflicto armado interno. Soacha, Colombia, 2019 / Social Determinants, Symptoms and Mental Problems in Adults Internally Displaced by Armed Conflict. Soacha, Colombia, 2019

resumen Objetivo: Caracterizar determinantes sociales en salud, problemas y síntomas mentales potencialmente problemáticos en adultos desplazados por conflicto armado interno en Colombia, asentados en Soacha. Métodos: Estudio descriptivo de corte transversal con tamaño muestral de 98 adultos desplazados por conflicto armado. Se aplicó el SelfReport Questionnaire para detección de problemas y síntomas mentales potencialmente problemáticos y un cuestionario estructurado sobre determinantes sociales en salud. Resultados: La mediana de edad fue 38 [intervalo intercuartílico, 28-46] años y predominaron las mujeres (69,39%). La mediana de tiempo desde que fueron desplazados fue 36 [16-48] meses y asentados en Soacha, 24 [5-48] meses. El 86,32% sobrevivía con menos de un salario mínimo mensual y el 93,87% no tenía contrato laboral. Un 42,86% y un 7,14% manifestaron ser propietarios de las viviendas que habitaban antes y después del desplazamiento respectivamente. Al llegar a Soacha, el 79,60% acudió a redes primarias y el 3%, a instituciones. El 16,33% carecían de aseguramiento en salud antes del desplazamiento y el 27,55%, después. Resultaron positivos en problemas mentales por posible trastorno depresivo o ansioso el 57,29%; en posible psicosis, el 36,73% y en síntomas potencialmente problemáticos, el 91,66%, más prevalentes y graves en mujeres (p = 0,0025). Conclusiones: Se identificaron en la población adulta desplazada y asentada en Soacha deterioro en condiciones de vida y una prevalencia de problemas y síntomas mentales potencialmente problemáticos mayor que la reportada en desplazados ubicados en otras regiones del país. Se requiere análisis con perspectivas complementarias para evaluar estas diferencias.

abstract Objective: To characterise social determinants of health, mental health problems and potentially problematic symptoms in the adult population displaced by internal armed conflict in Colombia. Methods: Cross-sectional descriptive study with a random sample of 98 adults forcefully displaced to Soacha, Colombia, due to internal armed conflict. The Self Report Questionnaire to detect potentially problematic mental health problems and symptoms, and a structured questionnaire on social determinants of health were applied. Results: The median age was 38 [interquartile range, 28-46] years, and women predominated (69.39%). The median time since displacement was 36 [16-48] months, and time since settlement in Soacha, 48 [5-48] months. 86.32% survived on less than the minimum wage per month and 93.87% did not have an employment contract. 42.86% and 7.14% reported being owners of their homes before and after displacement, respectively. Upon arriving in Soacha, 79.60% went to primary support networks and 3% to institutions. Before displacement, 16.33% lacked health insurance and 27.55% afterwards. Regarding mental health problems; there were possible depressive or anxious disorders in 57.29%; possible psycho-sis in 36.73%; and potentially problematic symptoms in 91.66%, being more prevalent and serious in women (P =0.0025). Conclusions: A deterioration in living conditions and a higher prevalence of potentially problematic mental health problems and symptoms was reported in displaced adult populations settled in Soacha compared to other regions of the country. Analyses with complementary perspectives are required to evaluate these differences.

Trastornos Psiquiátricos en Gestantes Hospitalizadas en el Servicio de Alto Riesgo Obstétrico de la Clínica Universitaria Bolivariana de Medellín (Colombia) Durante los Años 2013 a 2017 / Psychiatric Disorders in Pregnant Women Admitted to the High-Risk Obstetric Service in a Colombian University Clinic Between 2013 and 2017

RESUMEN Objetivos: Determinar los diagnósticos psiquiátricos y describir características clínicas, el riesgo biopsicosocial y los tratamientos de las pacientes hospitalizadas en el servicio de alto riesgo obstétrico para las que se realizó una interconsulta con psiquiatría. Métodos: Estudio observacional descriptivo en el que se incluyó a las pacientes del servicio de alto riesgo obstétrico de una institución de alta complejidad de Medellín para las que se interconsultó por psiquiatría de enlace entre 2013 y 2017. Las principales variables de interés fueron los diagnósticos y tratamientos tanto psiquiátricos como gineco obstétricos, además de los factores de riesgo obstétricos y psicosociales. Resultados: Se cribaron en total 361 historias clínicas, y 248 pacientes cumplían los criterios de inclusión. El diagnóstico psiquiátrico principal más prevalente fue trastorno depresivo mayor (29%), seguido por el trastorno de adaptación (21,8%) y los trastornos de ansiedad (12,5%); los fármacos más prescritos por psiquiatría fueron antidepresivos ISRS (24,2%), trazodona (6,8%) y benzodiacepinas (5,2%). El diagnóstico obstétrico principal más común fue el parto espontáneo (46,4%) y los diagnósticos obstétricos secundarios que predominaron fueron trastorno hipertensivo asociado con el embarazo (10,4%), diabetes gestacional (9,2%) y abortos recurrentes (6,4%). El 71,8% de las pacientes tenían un riesgo biopsicosocial alto. Conclusiones: Los principales diagnósticos psiquiátricos fueron trastorno depresivo mayor, trastorno de adaptación y trastornos de ansiedad, lo que implica la importancia del oportuno reconocimiento en la evaluación prenatal de los síntomas de estas entidades, conjuntamente con los factores de riesgo obstétrico y social. La intervención psiquiátrica es necesaria considerando las implicaciones negativas que tiene el alto riesgo tanto para la madre como paraelniño.

ABSTRACT Objective To determine the psychiatric diagnoses and treatments of patients admitted to the high-risk obstetric service who underwent a consultation with a liaison psychiatrist. Methods: A descriptive observational study that included pregnant women from the high-risk obstetric service of a highly specialised clinic in Medellín, who had a liaison psychiatry consultation between 2013 and 2017. The main variables of interest were psychiatric and obstetric diagnoses and treatments, in addition to biopsychosocial risk factors. Results: A total of 361 medical records were screened, with 248 patients meeting the inclusion criteria. The main prevailing psychiatric diagnosis was major depressive disorder (29%), followed by adaptive disorder (21.8%) and anxiety disorders (12.5%). The pharmacologic treatments most used by the psychiatry service were SSRI antidepressants (24.2%), trazodone (6.8%) and benzodiazepines (5.2%). The most common primary obstetric diagnosis was spontaneous delivery (46.4%), and the predominant secondary obstetric diagnoses were hypertensive disorder associated with pregnancy (10.4%), gestational diabetes (9.2%) and recurrent abortions (6.4%). Overall, 71.8% of the patients had a high biopsychosocial risk. Conclusions: The studied population's primary psychiatric disorders were major depressive disorder, adjustment disorder and anxiety disorders, which implies the importance of timely recognition of the symptoms of these perinatal mental pathologies, together with obstetric and social risks, in the prenatal consultation. Psychiatric intervention should be encouraged considering the negative implications of high biopsychosocial risk in both mothers and children.

Experiencia con la intervención DIALOG+ en pacientes con enfermedad mental grave en servicios de consulta externa de Colombia / Experience with the use of the DIALOG+ Intervention in Patients with Severe Mental Illness in Outpatient Services in Colombia

RESUMEN Introducción: Las enfermedades mentales graves producen un impacto significativo en términos de sufrimiento de los pacientes y sus familias, costos de atención y arios de vida perdidos por discapacidad. Este estudio pone a prueba la herramienta DIALOG+, una intervención basada en una App que combina una evaluación estructurada referente a 11 dominios, con un abordaje centrado en soluciones. Métodos: Estudio cualitativo anidado en un ensayo clínico controlado en el que 9 psiquiatras y una muestra intencional de 18 pacientes que utilizaron la aplicación DIALOG+ en controles mensuales durante 6 meses realizaron entrevistas semiestructuradas sobre su experiencia. Resultados: El análisis se enfocó en determinar la aceptabilidad, la viabilidad y la efectividad de la intervención en el contexto colombiano mediante el método de análisis temático inductivo propuesto por Braun y Clarke. Los resultados fueron: a) impactos en la consulta y la relación médico-paciente; b) impactos en los pacientes y promoción del cambio; c) uso de la aplicación, y d) adaptabilidad al sistema de salud. Conclusiones: El instrumento DIALOG+ fue valorado positivamente por la mayoría de los participantes, dado que aporta al seguimiento de los pacientes con enfermedad mental grave porque incluye un componente psicoterapéutico en las consultas habituales y mejora la comunicación y el paciente se apropia de su proceso. Sin embargo, es pertinente delimitar la población que podría percibir los mayores beneficios y ajustar su esquema, sobre todo en relación con el tiempo de consulta, para que resulte exitosa su adaptación al sistema de salud colombiano.

ABSTRACT Introduction: Severe mental disorders can cause significant and lasting distress for patients and their families and generate high costs through the need for care and loss of productivity. This study tests DIALOG+, an app-based intervention to make routine patient-clinician meetings therapeutically effective. It combines a structured evaluation of patient satisfaction with a solution-focused approach. Methods: We conducted a qualitative study, based on a controlled clinical trial, in which 9 psychiatrists and 18 patients used DIALOG+ monthly over a six-month period. Semistructured interviews were used to explore the experiences of participants and analysed in an inductive thematic analysis focusing on the feasibility and effects of the intervention in the Colombian context. Results: Experiences were grouped into five overall themes: a) impact of the intervention on the consultation and the doctor-patient relationship; b) impact on patients and in promoting change; c) use of the supporting app, and d) adaptability of the intervention to the Colombian healthcare system. Conclusions: DIALOG+ was positively valued by most of the participants. Participants felt that it was beneficial to the routine consultation, improved communication and empowered patients to take a leading role in their care. More work is required to identify the patient groups that most benefit from DIALOG+, and to adjust it, particularly to fit brief consultation times, so that it can be rolled out successfully in the Colombian healthcare system.

Biomarcadores electrofisiológicos en patología dual / Electrophysiological Biomarkers in Dual Pathology

resumen Introducción: Se denomina patología dual a la coocurrencia del trastorno por consumo de sustancias con al menos otro trastorno mental, que a su vez se caracteriza por una clínica heterogénea difícil de diagnosticar y de pobre respuesta al tratamiento. Por esto es necesario la identificación y validación de biomarcadores. Dentro de este grupo, se han reportado posibles biomarcadores electroencefalográficos útiles en el diagnóstico, el tratamiento y el seguimiento, tanto en condiciones neuropsiquiátricas como en trastornos por consumo de sustancias. Este artículo tiene como objetivo revisar la literatura existente acerca de biomarcadores electroencefalográficos en patología dual. Métodos: Revisión narrativa de la literatura. Se realizó una búsqueda bibliográfica en las bases de datos PubMed, Science Direct, OVID, BIREME y Scielo, con las palabras clave: biomarcador electrofisiológico y trastorno por uso de sustancias, biomarcador electrofisiológico y trastornos mentales, biomarcador y patología dual, biomarcador y trastorno por uso de sustancias, electroencefalografía y trastorno por uso de sustancias o trastorno mental comórbido. Resultados: Dado que se ha hallado mayor cantidad de literatura en relación con la electroencefalografía como biomarcador de enfermedades mentales y trastornos por consumo de sustancias y pocos artículos sobre patología dual, se organiza la evidencia como biomarcador en psiquiatría para el diagnóstico y la predicción del riesgo y como biomarcador para patología dual. Conclusiones: Aunque la evidencia no es concluyente, indica la existencia de subconjunto de sitios y mecanismos donde los efectos de las sustancias psicoactivas y la neurobiología de algunos trastornos mentales podrían traslaparse o interactuar.

abstract Introduction: The co-occurrence of substance use disorder with at least one other mental disorder is called dual pathology, which in turn is characterised by heterogeneous symptoms that are difficult to diagnose and have a poor response to treatment. For this reason, the identification and validation of biomarkers is necessary. Within this group, possible electroencephalographic biomarkers have been reported to be useful in diagnosis, treatment and follow-up, both in neuropsychiatric conditions and in substance use disorders. This article aims to review the existing literature on electroencephalographic biomarkers in dual pathology. Methods: A narrative review of the literature. A bibliographic search was performed on the PubMed, Science Direct, OVID, BIREME and Scielo databases, with the key**words: electrophysiological biomarker and substance use disorder, electrophysiological biomarker and mental disorders, biomarker and dual pathology, biomarker and substance use disorder, electroencephalography, and substance use disorder or comorbid mental disorder. Results: Given the greater amount of literature found in relation to electroencephalography as a biomarker of mental illness and substance use disorders, and the few articles found on dual pathology, the evidence is organised as a biomarker in psychiatry for the diagnosis and prediction of risk and as a biomarker for dual pathology. Conclusions: Although the evidence is not conclusive, it suggests the existence of a subset of sites and mechanisms where the effects of psychoactive substances and the neurobiology of some mental disorders could overlap or interact.

A 50 años de la exclusión de la homosexualidad del Manual diagnóstico y estadístico de los trastornos mentales (DSM) / 50 years after the exclusion of homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (DSM)

RESUMEN Se cumple medio siglo del hecho histórico constituido por la remoción de la homosexualidad como ítem diagnóstico en la clasificación norteamericana de trastornos psiquiátricos, es decir, en el Manual diagnóstico y estadístico de los trastornos mentales (DSM). Aunque es un período breve, cuesta trabajo creer que, hasta hace 50 años, las personas homosexuales carecían de numerosos derechos civiles elementales en EE. UU. y que diversas leyes penalizaban actos sexuales privados y libremente consentidos entre adultos. Rememorar estos hechos significativos en el contexto de una acotada reseña de la historia conceptual de la homosexualidad como trasfondo es el objetivo fundamental de este artículo que, a la vez, constituye un recordatorio de muchas tareas pendientes en la salud mental y derechos humanos de las minorías sexuales, todavía víctimas de homofobia, estigma y segregación, más aún en países como el nuestro.

ABSTRACT It is half a century since the historical event constituted by the removal of homosexuality as a psychiatric diagnosis from the North American Diagnostic and Statistical Manual of Mental Disorders (DSM). Although it is a short period of time, it is hard to believe that fifty years ago, homosexual people lacked many basic civil rights in the United States and various laws criminalized private, freely consented sexual acts between adults. Recalling these significant events in the context of a summarized conceptual history of homosexuality is the main objective of this brief account which, at the same time, can serve as a reminder of many tasks pending in the mental health and human rights of sexual minorities, still victims of homophobia, stigma, and segregation, even more so in countries like Peru.

Seroprevalencia de Toxoplasma gondii y su relación con trastornos mentales en adultos / Seroprevalence of Toxoplasma gondii and its Relationship with Mental Disorders in the Adult Population

El Toxoplasma gondii es un parásito que se encuentra, aproximadamente, en el 30 % de la población humana. Durante los últimos años se ha evidenciado que la infección latente puede ser un factor de riesgo para el desarrollo de trastornos mentales; particularmente para la esquizofrenia, ansiedad, trastornos bipolares y trastornos de conducta. La asociación con los trastornos neuropsiquiátricos pueden explicarse por la influencia que tiene el parásito sobre la expresión de múltiples neurotransmisores; entre ellos la dopamina. Se realizó una búsqueda en las bases de datos PubMed y SciELO de 2015 a 2023, se seleccionaron artículos originales y de revisión de revistas científicas internacionales, en idiomas inglés y español con el objetivo de describir la relación entre la seroprevalencia de T. gondii y el desarrollo de trastornos mentales en población adulta. Existe relación entre los trastornos mentales en la población adulta con la infección por Toxoplasma gondii y este aumenta la posibilidad de desarrollar esquizofrenia y depresión en individuos sin historial previo, y que podría exacerbar cuadros psiquiátricos previos con dificultad en el tratamiento. Sin embargo, no todos los datos estadísticos establecen una relación directa, algunos estudios demuestran una asociación, ciertos datos son discordantes, lo que abre una puerta para futuras investigaciones.

Toxoplasma gondii is a parasite that is found in approximately 30 % of the human population. In recent years, it has been shown that latent infection can be a risk factor for the development of mental disorders; particularly schizophrenia, anxiety, bipolar disorders, and conduct disorders. The association with neuropsychiatric disorders can be explained by the influence of the parasite on the expression of multiple neurotransmitters; among them, dopamine has received the most attention. A narrative bibliographic review article was done with the search of original and review articles in international scientific journals, in English and Spanish listing the relationship between the seroprevalence of T. gondii and the development of mental disorders in the adult population. The relationship between mental disorders in the adult population with Toxoplasma gondii infection is present and increases the possibility of developing schizophrenia and depression in individuals with no previous history, including the ability to worsen previous psychiatric conditions, making it difficult for standard management. Not all statistical data establish a direct relationship, some studies show an association and certain data are discordant, which opens a door for future research.

Research Progress in Tong Du Tiao Shen of Mental Disorders / 世界科学技术-中医药现代化

Mental disorders are characterized by disturbances in behavior,volition,emotion,and cognition and are considered emotional diseases in traditional Chinese medicine.Acupuncture is one of the most widely used complementary alternative therapies for the treatment of mental disorders.Recently,there has been growing interest in the use of the Tong Du Tiao Shen(Dredging Du meridian to regulate the spirit)as a primary treatment.However,a comprehensive summary of the establishment and related acupuncture methods of Tong Du Tiao Shen is lacking.This paper aims to address this gap by exploring the origin and development of Tong Du Tiao Shen,its application in treating mental disorders,and the modern biological mechanisms involved.Ultimately,this paper seeks to expand the clinical application of Tong Du Tiao Shen acupuncture and provide a scientific basis for future research in this field.

China's service system for community residents with severe mental disorders： achievements， challenges and prospects / 四川精神卫生

With the implementation of the 'Mental Health Law of the People's Republic of China' and relevant policies， governments at all levels have devoted more resources to community-based rehabilitation services for patients with mental disorders， making the mental health services more accessible and professional to the majority of patients with mental disorders. Monumental achievements have been made in community-based rehabilitation services for patients with severe mental disorders， while challenges have always existed in the China's community mental health service system for patients with severe mental disorders. Therefore， this article elaborated the achievements， challenges and prospects of China's community mental health service system for patients with severe mental disorders， aiming to provide references for future work and further improve the quality and accessibility of community mental health service for patients with mental disorders.

Prevalence and sociodemographic determinants of common mental disorders (CMDs) symptoms in a rural adult population of Haryana, North India / Journal of Rural Medicine

Objectives: Common mental disorders (CMDs), including depression, anxiety, and somatoform disorders, affect all stages of life and impact individuals, families, and communities. This study aimed to determine the magnitude of CMDs and their sociodemographic determinants in the adult population of a rural block in North India.Material and Methods: A cross-sectional, quantitative, community-based study was conducted among adult residents of a rural block in Haryana, North India, using a multistage random sampling technique. The Hindi version of the General Health Questionnaire (GHQ-12), a well-validated tool, was used to screen participants for CMDs. Scores of 4 or above denoted the presence of CMDs. Bivariate analyses were performed to determine the associations between CMDs and sociodemographic characteristics.Results: Of the 180 residents selected for the study, most were women (60.0%) and aged between 31 and 50 years (52.3%). The prevalence of CMDs symptoms in the study population was 20.0%. The presence of CMDs symptoms was significantly higher among those who were aged 60 years or older [OR=12.33, 95% CI 3.21–47.38], widowed, divorced or separated [OR=7.50, 95% CI 1.09–51.52], illiterate [OR= 6.25, 95% CI 2.84–13.77], had monthly family income below 10,000 INR [OR=3.33, 95% CI 1.54–7.20], had any chronic physical illness [OR=8.28, 95% CI 3.70–18.56] and had a family history of any psychiatric illness [OR=5.56, 95% CI 1.52–19.42].Conclusion: The burden of CMDs was quite high among adults in rural North India. The presence of CMDs was closely associated with sociodemographic characteristics. Primary care and community-based settings need to screen for, diagnose, and manage CMDs to address this growing problem.

Ethical Considerations and Countermeasure Analysis of Public Mental Disorders Stigma in China / 中国医学伦理学

Discrimination against patients with mental disorders and the resulting stigma will not only affect patients’ medical treatment, but also bring about community isolation and lack of resources. Mental health problems have become a major public health problem and a prominent social problem. From the perspective of bioethics, the existence of public mental disorders stigma violates the principles of justice and respect. This paper quantitatively described the status quo of public mental disorders stigma in China, and explored its influencing factors through factor analysis and binary logistic regression analysis. The public stigma of mental disorders score was (54.64±11.048). Factor analysis extracted 4 common factors, namely isolation, pain, contact, and empathy, with a cumulative explained variance of 68.948%. The results showed that age and contact history were the main factors affecting the public stigma of mental disorders. It is recommended to reduce discrimination by enhancing understanding and improving empathy. Specifically, it is to implement the personal liability for discrimination through ethical regulation and legal construction, and strengthen the concept of a community of shared future for mankind by creating a tolerant social atmosphere, so as to achieve an appropriate balance between public safety and individual rights and interests.

A qualitative study of effect of psychodrama therapy in adolescent inpatients with mental disorders / 中国心理卫生杂志

Objective:To explore the effect of psychodrama therapy in adolescent inpatients with mental disor-ders.Methods:Totally 22 patients with mental disorders(aged 12-18 years)were recruited from the inpatient children's ward of a certain hospital.According to the interview outline,a semi-structured interview was conducted in adolescent inpatients with mental disorders who participated in 4 sessions of psychodrama therapy.These patients took psychotropic drugs regularly.The interview data were analyzed in depth by using the grounded theory meth-od.The self-compiled Psychodrama Therapy Participation Feeling and Evaluation Questionnaire was used to investi-gate the feelings,gains or changes of patients after psychodrama therapy.Results:The interview analysis found that the effects of psychodrama therapy included reducing symptoms,improving self-esteem,promoting functional recov-ery and improving social adaptability.The results of the self-compiled Psychodrama Therapy Participation Feeling and Evaluation Questionnaire showed that the top 4 aspects were promoting interpersonal relationship,being inter-esting,willing to continue to participate and improving self-confidence.Conclusion:Psychodrama therapy has an auxiliary therapeutic effect in adolescent inpatients with mental disorders,and can promote the improvement of self-esteem and social skills.

Advances in applications of neuroregulatory techniques in research on brain sciences / 中国药理学与毒理学杂志

Drugs and physical stimulation,including light,electricity,and magnetic fields,can be used to influence how neurons operate,among which chemogenetic and optogenetic technologies are most widely used.In recent years,magnetogenetic technology has also been developed that can acti-vate neurons in magnetic fields through magnetic sensitive actuators,leading to non-invasive and instanta-neous activation of specific brain regions.This article reviews the evolution of and problems with chemoge-netic and optogenetic techniques commonly used in brain science research.It also outlines the latest progress in magnetogenetic technologies,which are not full-fledged yet,as well as the role of transcra-nial electrical stimulation,transcranial magnetic stimulation,deep brain stimulation and transcranial ultra-sound stimulation technology in the functional regulation of brain diseases.Constant adjustment and improvement can make it possible for these technologies to be used more widely for the study of brain sciences and the treatment of brain diseases.

Associations of serum gamma-linolenic acid levels with erythema severity and anxiety/depression status in patients with rosacea

Abstract Background The development of rosacea is suggested to be closely associated with lipid metabolism, inflammation, and anxiety/depression. Gamma linolenic acid (GLA) is a key factor participating in lipid metabolism, which is also confirmed to regulate the inflammatory response. However, the associations of serum GLA levels with rosacea severity and psychological status still remain unclear. Objective and limitations of the study The present study aimed to investigate the associations of gamma linolenic acid (GLA), a key factor participating in lipid metabolism and the inflammatory response, with rosacea severity and psychological status. The present study still had some limitations. First, this study is a cross-sectional study and does not provide longitudinal evidence about the relationship between GLA and rosacea; Second, the cohort in this study is also relatively small, and a larger cohort is needed in further investigation to reveal the potential role of lipid metabolism in the pathogenesis of rosacea. Methods A total of 62 rosacea patients were consecutively recruited. Patient's Self-Assessment (PSA) scale and Clinician Erythema Assessment (CEA) as well as 7-item Generalized Anxiety Disorder (GAD-7) and 9-item Patient Health Questionnaire (PHQ-9) were conducted to evaluate the degree of erythema severity and anxiety/depression, respectively. Serum GLA levels were determined by gas chromatography mass. Results Lower levels of serum GLA in rosacea patients were observed (p < 0.001), and subgroup analysis revealed that patients with higher-level GLA had lower scores of PSA, CEA, GAD-7 and PHQ-9. Moreover, Spearman correlation analysis uncovered that serum GLA levels were negatively associated with PSA, CEA, GAD-7 as well and PHQ-9 scores, respectively. Linear regression model found that serum GLA levels at baseline were a predictive factor for prognosis of clinical outcomes after 1-month conventional treatment. Conclusion The present study indicates that lower levels of serum GLA in rosacea patients are negatively associated with the degree of erythema and anxiety/depression status.