Training effect and influencing factors of transfer training for psychiatrists in Sichuan province / 四川精神卫生

ObjectiveTo investigate the effect and influencing factors of transfer training for psychiatrists in Sichuan province， and to provide references for development of psychiatric personnel training program. MethodsThe qualified trainees who completed the phase I-IV transfer trainings at six regional mental health centers of Sichuan province from January 2015 to December 2018 were enrolled. All the selected trainees underwent three stages of systematic training： theoretical study， clinical practice and community practice. Moreover， trainees were given a closed-book examination at the end of the first stage of theoretical training and the third stage of community practice， and the examination results were used as indicators to assess the effectiveness of the training. ResultsThe trainees of different educational background， age， hospital type， hospital level and clinical practice bases had statistically different examination results （P<0.05 or 0.01）. The results of both examinations of the trainees in transfer training were all better than those of the residents in standardized training ［（77.00±8.55） vs. （70.90±6.81）， （77.24±8.80） vs. （69.00±7.66）， P<0.05］. ConclusionEducational requirements （bachelor's degree and above） and reasonable allocation of clinical practice bases may be the important measures to enhance the effect of transfer training for psychiatrists.

Beliefs About Spiritual Pain among Palliative Care Physicians and Liaison Psychiatrists: A Nationwide Questionnaire Survey

Objectives: Spiritual pain is not formally defined. The aim of this study was to clarify the beliefs about spiritual pain among Japanese palliative care physicians and liaison psychiatrists and to compare their beliefs. Methods: A nationwide questionnaire survey was conducted by mail August, 2019 on certified palliative care physicians and liaison psychiatrists. We asked 9 questions about spiritual pain (i.e. current status, definition, and the delivery of care) using a 5-Likert scale. Result: 387 palliative care physicians (response rate, 53%) and 374 psychiatrists (45%) responded. 72% (76% of the palliative care physicians/69% of the psychiatrists) reported that spiritual pain was distinct from depression, but 69% (66/71) reported that it was not defined adequately; and 59% (59/60) perceived the risks of using the words ambiguously. Only 43% (40/47) recommended the universal definition of spiritual pain, and opinions about how spiritual pain should be defined (i.e, higher being, meaning/value, or specific terms) differed among physicians. Perception about spiritual pain of the physicians were significantly associated with their religion, while beliefs about spiritual pain were essentially similar between palliative care physicians and psychiatrists. Conclusion: Although physicians regarded the definition of spiritual pain as being inadequate, the opinions about preferable definition differed among physicians. Discussion about the value of developing a consensus of spiritual pain is needed.

The incidence, pattern and management of sexual assault in a tertiary hospital in North-western Nigeria

Background: Sexual assault is any sexual act performed by one person on another without the person’s consent or on a victim who is incapable of giving consent. It is a violation of basic human rights, a gender-based issue and a violent crime against both the individual and the society. The objectives of the study were to determine the incidence, pattern and management of sexual assault in Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.Methods: This was a 10 - year retrospective study. Case records of sexual assault from 1st January, 2007 to 31st December, 2016 were retrieved and relevant data extracted and analyzed using the SPSS for windows version 20.0Results: The incidence of sexual assault was 0.8%. Majority, 88 (85.4%) occurred in children and adolescents. Peno-vaginal penetration was the most common form of assault 65 (63.1%) and the assailants were known to the victims in 74 (71.9%) of the cases. Involvement of psychiatrists/psychologists in the management of the victims was poor as psychiatrists were involved in only 13 (12.6%) of the cases. Most of the victims were lost to follow up.Conclusions: Sexual assaults occurred mostly in children and adolescents in this study. Increased public awareness and preventive interventions are required especially among the at-risk age groups to enhance their safety. Training of relevant persons in the institution to offer counselling to the victims is recommended as referral for psychiatrists’ consultation was poor. It is important to institute a good tracking system to follow up the victims as most are lost to follow up.

Physicians specializing in psychiatry of Mexico: An update 2018 / Médicos especialistas en psiquiatría de México: actualización 2018

Abstract Introduction In 2016, there were 4,393 psychiatrists in Mexico, with an estimated rate of 3.68 per 100,000 inhabitants. It is essential to keep this information updated in order to achieve the overall objectives of mental health care. Objective Estimate the total number of psychiatrists and paidopsychiatrists in Mexico in 2018; identify their geographical distribution, and compare the results with those obtained in 2011 and 2016. Method Comparative, longitudinal study. Various sources were consulted to update the number of psychiatrists and paidopsychiatrists in 2018 and to determine their sociodemographic characteristics. These characteristics were compared with those found in 2011 and 2016. Results A total of 4,999 specialists in psychiatry practiced their specialty in Mexico in 2018, 365 of whom are child and adolescent psychiatrists. A rate of 3.71 psychiatrists per 100,000 inhabitants was obtained for a population of 124,737,789. Regarding pedopsychiatric specialists, if we consider a population of 37,714,991 inhabitants under 16, the corresponding rate is .96 child and adolescent psychiatrists per 100,000 minors. These specialists are unevenly distributed throughout the country. Approximately 60% of all psychiatrists and child and adolescent psychiatrists practice in the three largest cities in Mexico. Discussion and conclusion Although the national rate of psychiatrists was increased in comparison with 2016, it is still lower than that recommended by the World Health Organization (WHO). The geographical distribution of psychiatrists is uneven due to centralization and economic factors as happens in many countries in the world.

Resumen Introducción En 2016 se contabilizaron en México 4,393 psiquiatras, con una tasa estimada de 3.68 por cada 100,000 habitantes. Es necesario mantener actualizada esta información para alcanzar los objetivos globales de atención a la salud mental. Objetivo Estimar el número total de psiquiatras y paidopsiquiatras en México en 2018; determinar su distribución geográfica y comparar los resultados con los obtenidos en 2011 y 2016. Método Estudio comparativo y longitudinal. Se consultaron diversas fuentes para actualizar el número de psiquiatras y paidopsiquiatras en 2018 y conocer sus características sociodemográficas. Se compararon estas características con las encontradas en 2011 y 2016. Resultados Un total de 4,999 especialistas en psiquiatría ejercen su especialidad en México en 2018 y de estos 365 son paidopsiquiatras. En una población de 124,737,789 habitantes, se obtuvo una tasa de 3.71 psiquiatras por cada 100,000 habitantes. Respecto a los especialistas en paidopsiquiatría, si consideramos una población de 37,714,991 habitantes menores de 16 años, la tasa correspondiente es de .96 paidopsiquiatras por cada 100,000 menores. Existe una distribución desigual de estos especialistas en el país. Alrededor del 60% de todos los psiquiatras y paidopsiquiatras ejercen en las tres mayores ciudades de México. Discusión y conclusión Aunque la tasa nacional de psiquiatras se incrementó en comparación con la obtenida en 2016, sigue siendo todavía menor a la recomendada por la Organización Mundial de la Salud. La distribución geográfica de los psiquiatras es inequitativa debido a la centralización y a factores económicos como sucede en muchos países del mundo.

The need for information and training among staff of psychiatric clinics / Монголын Анагаах Ухаан

Background@#Information and technology knowledge is important for the medical and non-medical staff of hospitals, regardless of their position. @*Aim@#To study needs for information and advanced training among medical professionals. @*Material and Method@#Using a survey questionnaire, the need for information of medical professionals, as well as the ability to independently receive and process the information received, was studied. Data was collected anonymously and obtained informed consent. @*Results@#A high need for up-to-date information among doctors was revealed; the willingness to work with information varied significantly depending on the age of the respondents. When assessing the possibility of satisfying the information, it was found that the available information support does not meet the modern requirements of medical workers in reference books and convenient mobile applications. The lack of commitment of doctors to the principles of evidence-based medicine, most often due to the difficulty in finding sources, was revealed. The possibilities of training doctors of different age groups are evaluated. @*Conclusion@#Organizational solutions are proposed to enhance the professional competencies of psychiatrists regarding the practical application of legislation.

El aporte docente de los psiquiatras a la psicología: Cuatro personajes a la luz de la historia de la psicología en Arequipa / Teaching contribution of psychiatrists to psychology: Four figures in the history of psychology in Arequipa

El presente artículo se centra en el aporte docente de cuatro psiquiatras peruanos durante el periodo de creación de la Escuela de Psicología de la Universidad Nacional de San Agustín en Arequipa. Estos profesionales (Carlos Neuenschwander Landa, Noel Altamirano Velasco, Marco Carpio Bernedo y Claudio Mendívil Echevarría) transmitieron sus enseñanzas y experiencias a las primeras generaciones de psicólogos arequipeños. Se analiza su formación y su contribución a la psicología a través de su valiosa labor docente.

This article focuses on the educational contribution of four Peruvian psychiatrists during the process of creation of the School of Psychology at the National University of San Agustin in Arequipa. These professionals (Carlos Neuenschwander Landa, Noel Altamirano Velasco, Marco Carpio Bernedo y Claudio Mendivil Echevarría) transmitted their knowledge and experiences to the first generations of psychologists trained in the city. Their formation and contribution to psychology are analyzed through an examination of their valuable educational labor.

Psychiatric Symptoms in Teachers from Danwon High School after Exposure to the Sinking of the Motor Vessel Sewol

OBJECTIVE: The goal of this study was to describe the psychiatric symptoms in the teachers from Danwon High School who were exposed to the sinking of the Motor Vessel Sewol. METHODS: Data were collected from 32 teachers who underwent psychiatric interventions by 16 volunteer psychiatrists for 3 months after the sinking of the Motor Vessel Sewol. RESULTS: The most commonly diagnosed clinical diagnosis in the teachers were normal reaction, acute stress disorder and adjustment disorder. Psychiatric symptoms including anxiety, depressed mood and sleep disturbances were also observed. CONCLUSION: In the acute aftermath of the Sewol Ferry sinking on April 16, 2014, psychiatrists volunteered to provide professional psychiatric interventions to Danwon High School teachers. These results suggest the importance of crisis intervention focused on the teachers who are exposed to disasters. The implications for future research and interventions are discussed.

Perspectiva de los pacientes sobre el tratamiento combinado de psicoterapia y farmacoterapia / Patients' perspective on combined treatment of psychotherapy and pharmacotherapy

La investigación sobre Tratamientos Combinados (TC) se ha centrado en estudiar los criterios que utilizan los profesionales a la hora de implementar este tipo de abordaje, pero son escasas las investigaciones que permitan conocer la perspectiva del paciente respecto a este tipo de tratamiento. Este es un estudio exploratorio, cualitativo conformada por 49 sujetos, residentes en CABA y GBA, que han recibido TC en los últimos dos años o lo están recibiendo en la actualidad, con el fin de evaluar los siguientes aspectos: 1) orientación teórica de profesionales; 2) comunicación entre profesionales; 3) efectos adversos de los tratamientos; y 4) experiencias de los pacientes respecto al TC. Los resultados preliminares sugieren que los pacientes en su mayoría conocen el tipo de tratamiento que realizan los psicólogos, siendo mucho menor el porcentaje de pacientes que conoce el tratamiento aplicado por su psiquiatra. En lo que respecta a informar los efectos adversos de los tratamientos son los psiquiatras quienes lo hacen en la mayoría de los casos pero es alta la cifra de pacientes que no han recibido esta información de ningún profesional tratante. Los pacientes presentan mayormente experiencias positivas respecto al TC basadas principalmente en la potenciación de los tratamientos y la contención de ambos profesionales. En lo que concierne a las experiencias negativas, la mala comunicación entre profesionales es la característica destacada. Este estudio se encuentra en proceso y sus conclusiones son provisionales.

Research on Combined Treatment (CT) is based largely on studies that seek to explore the criteria used by professionals involved in the combined therapies, though, there is little research exploring the perspective of CT users. We perform an exploratory qualitative study. A questionnaire was administered to 49 patients from CABA and GBA that are having CT or had been received it during the last two years to assess the following aspects: 1) professional´s theoretical orientation; 2) communication among professionals; 3) Side effects of treatments; and 4) patient experience regarding CT. Preliminary results suggest that most patients know the type of treatment carried out by psychologists, being lower the percentage of patients who know the psychiatric treatment. Regarding providing information about treatments side effects, psychiatrists reported in most cases, but there is a high number of patients who have not received this information from any treating professional. Concerning patient´s perspective on CT, the majority have positive experiences, being highlighted the empowerment of both treatments and professional care. On the other hand, bad communication between treating professionals were emphasized among negative experiences. This study is ongoing so its conclusions are tentative.

Los especialistas en psiquiatría en México: año 2016 / Specialty in psychiatry: Mexico 2016

RESUMEN: Introducción: En el año de 2011 había en México 3 823 psiquiatras, con una tasa estimada de 3.4 por cada 100 mil habitantes. Es necesario mantener actualizada esta información para alcanzar los objetivos globales de atención a la salud mental. Objetivo: Estimar el número total de psiquiatras en México en 2016; determinar su distribución geográfica y comparar los resultados con los obtenidos en el año 2011. Método: Estudio comparativo y longitudinal. Se consultaron diversas fuentes para actualizar el número de psiquiatras en 2016 y conocer sus características sociodemográficas. Se compararon estas características con las encontradas en 2011. Resultados: Un total de 4 393 psiquiatras ejercen su especialidad en México en 2016. Sobre una población de 119 530 753 habitantes, se obtuvo una tasa de 3.68 psiquiatras por cada 100 000 habitantes. Existe una pobre distribución de estos especialistas en el país. Alrededor del 60% de todos los psiquiatras ejercen en las tres mayores ciudades de México. Discusión y conclusión: La tasa nacional de psiquiatras se incrementó en comparación con la obtenida en 2011, sigue siendo inferior a la recomendada por la Organización Mundial de la Salud (OMS). La distribución geográfica de los psiquiatras es inequitativa debido a la centralización y a factores económicos.

ABSTRACT: Introduction: In 2011 we had 3823 psychiatrists in Mexico, with an estimated rate of 3.4 per 100 000 inhabitants. In order to achieve the global targets of mental health attention, it is important to update this information. Objetive: To estimate the total number of psychiatrists in Mexico in 2016; detemine their geographic distribution and compare the results with the ones obtained in 2011. Method: Longitudinal and comparative study. Diverse sources of information were consulted in order to update the number of psychiatrists in 2016 and to know their sociodemographic characteristics, that were compared with the ones obtained in 2011. Results: 4 393 psychiatrists practiced their specialty in Mexico in 2016. With a population of 119 530 753 inhabitants, we obtained a rate of 3.68 psychiatrists per 100 000 inhabitants. There's a poor distribution of theese specialists in the country. Around 60% of all psychiatrists practice in the tree major cities of Mexico. Discussion and conclusion: The national rate of psychiatrists increase in comparisson with the one we found in 2011, it remains lower that the one recommended by the World Health Organization (WHO). Geographic distribution of the psychiatrists is inequitative because of centralization and economic factors.

Psychotherapy Practice Among Child And Adolescent Psychiatrists In Thailand

To survey patterns of psychotherapy practice of child and adolescent psychiatrists in Thailand, including identifying obstacles to conduct psychotherapy. Methods: This was a cross-sectional descriptive study. A selfreported questionnaire was developed by the authors and sent to all child and adolescent psychiatrists in Thailand by mail. Results: The total number of child and adolescent psychiatrists in Thailand at the time of the survey was 176. There were 95 respondents (54.0 % response rate), with the average age of 39.7 ± 9.8 years old. 67 (70.5%) respondents were female. Respondents endorsed conceptual frameworks used in case formulation and treatment planning as following: learning and cognitive theory (68.8 %), Eriksonian theory (41.3 %) and attachment theory (34.8%). Only 6.4 % of respondents reported that they provided psychotherapy to their patients “frequently” and “very frequently”. Instead, the majority of respondents provided just only counseling and parenting advice & guidance, parent management therapy (PMT). Respondents estimated that 36.3 ± 24.0 % of their patients should be treated with psychotherapy but in real-life practice, they provided psychotherapy for 5.1 ± 8.6 patients/ week in the past year. Psychotherapies that most children and adolescent psychiatrists used were behavioral therapy, supportive psychotherapy and cognitive-behavioral therapy (73.3 %, 71.8 %, and 56.5% of respondents reported to conduct “frequently” and “very frequently," respectively). Main obstacles in performing psychotherapy were heavy workload, lack of readiness of patients and lack of confidence by child and adolescent psychiatrists. Conclusion: Although psychotherapy is considered an essential treatment in child and adolescent psychiatry practice, child and adolescent psychiatrists in Thailand provide psychotherapy to only a small number of patients. Behavioral therapy, supportive psychotherapy and cognitive-behavioral therapy were the most frequently used psychotherapiesby Thai child and adolescent psychiatrists. Lack of time to engage in psychotherapy due to heavy workload was the most common obstacle in providing this treatment. ASEAN Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.

Current Human Rights Education for Psychiatrists Leaves Much to Be Desired / 신경정신의학

OBJECTIVES: Human rights education programs have been implemented annually since Korea enacted human rights legislation in 2009. The purpose of this study was to investigate attitudes of Korean psychiatrists toward human rights education and assess the relevance of the provided education materials. METHODS: Questionnaires comprised of 8 items were provided to 274 psychiatrists attending the April 2015 Korean Neuropsychiatric Association seminar. In addition, 12 cases related to education material developed by the Korean National Human Rights Commission were examined to determine whether the material's content was relevant and appropriate for human rights education. RESULTS: Data from 267 psychiatrists that answered all requested questions were included in the analysis. Although respondents in general accepted the beneficial intent of human rights education, the majority of respondents (71.5%) disagreed with the mandatory 4 h of annual human rights education. Approximately half of respondents (49.4%) believed that frequency of such education should be decreased. A substantial percentage of respondents (38.7%) expressed overall dissatisfaction with the education program, and more than half of respondents (55.6%) were skeptical that the current education program could produce a real difference in attitudes toward human rights. The case reviews highlighted several problems. First, all education materials were heavily weighted toward psychiatric hospitalization legal proceedings rather than human rights. Among the 12 cases examined, four were considered inappropriate for human rights education because they were presented as if human rights abuse was synonymous with violation of a law, even if the law was ambiguous. CONCLUSION: The current human rights education program does not meet psychiatrists' expectations. The results of this study suggest there is a need to reconsider the purpose and means of providing human rights education to psychiatrists.

O cérebro produz a mente? Um levantamento da opinião de psiquiatras / Does the brain produce the mind? A survey of psychiatrists’ opinions

Psychiatrists’ views on the mind-brain relationship (MBR) have marked clinical and research implications, but there is a lack of studies on this topic. Objectives: To evaluate psychiatrists’ opinions on the MBR, and whether they are amenable to change or not. Methods: We conducted a survey of psychiatrists’ views on the MBR just before and after a debate on the MBR at the Brazilian Congress of Psychiatry in 2014. Results: Initially, from more than 600 participants, 53% endorsed the view that “the mind (your “I”) is a product of brain activity”, while 47% disagreed. Moreover, 72% contested the view that “the universe is composed only of matter”. After the debate, 30% changed from a materialist to a non-materialist view of mind, while 17% changed in the opposite way. Discussion: Psychiatrists are interested in debates on the MBR, do not hold a monolithic view on the subject and their positions are open to reflection and change, suggesting the need for more in-depth studies and rigorous but open-minded debates on the subject...

Psychiatrists’ views on the mind-brain relationship (MBR) have marked clinical and research implications, but there is a lack of studies on this topic. Objectives: To evaluate psychiatrists’ opinions on the MBR, and whether they are amenable to change or not. Methods: We conducted a survey of psychiatrists’ views on the MBR just before and after a debate on the MBR at the Brazilian Congress of Psychiatry in 2014. Results: Initially, from more than 600 participants, 53% endorsed the view that “the mind (your “I”) is a product of brain activity”, while 47% disagreed. Moreover, 72% contested the view that “the universe is composed only of matter”. After the debate, 30% changed from a materialist to a non-materialist view of mind, while 17% changed in the opposite way. Discussion: Psychiatrists are interested in debates on the MBR, do not hold a monolithic view on the subject and their positions are open to reflection and change, suggesting the need for more in-depth studies and rigorous but open-minded debates on the subject...

Reported Experiences of Stalking Behavior from Patients towards Psychiatrists from the Atlantic Provinces of Canada.

Aim: A study was conducted to assess the magnitude of stalking experienced by psychiatrists, its’ effects and actions taken to ameliorate the problem. Methods: A cross sectional study to assess the magnitude of stalking the consequent effects on the psychological, social and occupational life of psychiatrists; and any preventative measure taken was conducted from July 2009-April 2010. A questionnaire was sent to 301 psychiatrists practicing in Atlantic Canada. Local Ethics approval was obtained. Results: Of the 308 psychiatrists sent surveys, 116 responded (37.6%; 67 males and 47 females). One questionnaire was invalid. (Twenty-nine (15 males and 14 females) reported experiences of stalking. Fifty-eight (50.4%) were above age 50, 49(42.6%) were between ages 35-50 and (8) 7% were younger than 35. In the study cohort, 39(33.6%) psychiatrists were in pure clinical practice, 4(3.4%) were in academic practice and 71(61.2%) had combined clinical and academic practice. Among the subspecialties, 73(62.9%) psychiatrists were practicing general adult psychiatry, 19(16.4%) were child and adolescent psychiatrists, 6(5.2%) in geriatric psychiatry, 4(3.4%) in consultationliaison, 5(4.3%) in forensic, 1(0.9%) in developmental disability and 7(6.0%) were in other psychiatric specialties. Of 115 psychiatrists, 53(46.1%) were in practice for more than 15 years, 16 (13.9%) were from 11–15 years, 29 (25.2%)-from 5 to 10 years and 17(14.8%) were in practice for less than 5 years. There was no significant differences [OR (Odds Ratio values), p-values>0.05) in reported stalked for age or length of psychiatric practice. However, there was strong association of stalking with the distress experienced by the psychiatrists (p=0.00). Conclusion: The problem of stalking does exist in the Atlantic Provinces of Canada and causes immense psychological, professional and social distress among psychiatrists who fall victim to stalking behavior. The majority of mental health professionals are unaware of any laws against stalking in Canada. There is a need for more effective education, support services and redress if we are to ameliorate the burden associated with stalking behaviours.

Los especialistas en psiquiatría en México: su distribución, ejercicio profesional y certificación / Phychiatrists in Mexico: their distribution and practice

There are few available and reliable data regarding the number and geographic location of psychiatrists in Mexico. It is important to have these data in order to know if the mental health needs of the country are being met. This study is an attempt to update both the current data on this subject by locating the most psychiatrists possible, and also to learn more about how they manage their medical practice. Methods Descriptive and cross-sectional study. Several sources available in Mexico were consulted such as Mexican Psychiatry Associations, health care institutions, universities, telephone directories among several others, to locate psychiatrists and to identify where and what kind of practice they have. Results According to our several data bases, 3823 psychiatrists were counted in Mexico, 225 of these being child and adolescent psychiatrists. The rate of psychiatrists obtained was 3.47 psychiatrists per 100 000 inhabitants and 0.69 child and adolescent psychiatrists per 100 000 inhabitants under 15 years. 56% of psychiatrists practiced in the Federal District. There are 1.8 male psychiatrists for every female psychiatrist. Discussion The number of psychiatrists in Mexico is still below the rate that the World Health Organization recomends. The distribution by gender is shifting towards more equality. Psychiatrists were found to be grouped in urban areas of the country. The number of psychiatrists and child and adolescent psychiatrists seems to be insufficient to cover the needs of the country.

Existe poca información disponible y actualizada acerca del número de psiquiatras en México y sobre su localización geográfica. Es importante conocer estos datos para saber si se cubren las necesidades de salud mental del país. Este estudio busca actualizar tanto los datos disponibles sobre este tema al localizar el mayor número de psiquiatras posibles, como el tipo de práctica en su especialidad y si cuentan con la certificación correspondiente. Metodología Se trata de un estudio descriptivo y transversal. Se consultaron múltiples fuentes disponibles en México, como las asociaciones psiquiátricas mexicanas, las instituciones hospitalarias, las universidades, los directorios telefónicos y otros, para localizar a los psiquiatras, identificar dónde ejercen y conocer el tipo de su práctica profesional. Resultados Considerando nuestras diversas fuentes de búsqueda, se contabilizó un total de 3 823 psiquiatras para una población total de 112 000 000 de habitantes. Del número total de psiquiatras, 225 tienen la subespecialidad de paidopsiquiatría. Se obtuvo una tasa de 3.47 psiquiatras por cada 100 000 habitantes y de 0.69 paidopsiquiatras sobre una población de 100 000 habitantes menores de 15 años. El 56% se encuentra en el Distrito Federal. Hay 1.8 psiquiatras varones por cada mujer en esa especialidad. Discusión El número de psiquiatras en México aún está por debajo de la tasa recomendada por la Organización Mundial de la Salud. La distribución por género está cambiando hacia una más equitativa. Se encontró que los psiquiatras están agrupados en las zonas urbanas del país. El número de psiquiatras y paidopsiquiatras es insuficiente para cubrir las necesidades de salud mental del país.

Calidad de vida en psiquiatras infanto-juveniles, neuropediatras y residentes de psiquiatría infanto-juvenil: uso de la encuesta WHOQOL-BREF / Quality of life in children and adolescents psychiatrists and neurologists: use of WHOWOL-BREF survey

El presente estudio se basa en la Encuesta de Calidad de Vida de la Organización Mundial de la Salud (WHOQOL-BREF), que se utilizó para analizar la calidad de vida y los factores que contribuyen a su calidad de vida en Psiquiatras Infanto-Juveniles y Neuropediatras, además de residentes de ambas especialidades en Chile. Se realizaron entrevistas electrónicas a 79 profesionales, asociados a la Sociedad de Psiquiatría y Neurología de la Infancia y de la Adolescencia. Los resultados mostraron que las puntuaciones medias en cada dominio del WHOQOL-BREF de los profesionales son las siguientes: la capacidad física (CF) es de 15,11 +/- 2.55, el bienestar psicológico (BP) fue de 15,22 +/- 2.08, relaciones sociales (RS) fue 14,63 +/- 2.75 y el medio ambiente (MA) 15,04 +/- 2.39. Estas puntuaciones medias fueron inferiores a las de la población general. Por último, se realizaron regresiones múltiples por pasos para examinar las características del Psiquiatra Infanto-Juvenil, Neurólogo Infantil y residentes de la especialidad. El estudio encontró que los siguientes tres factores: la percepción subjetiva del estado de salud, los hogares, los ingresos y el estrés de apoyo familiar insuficiente, fueron significativamente correlacionados con los cuatro dominios de regresión múltiple análisis. Los resultados destacan que los cuidadores de los niños y adolescentes con discapacidad intelectual parecen mostrar una menor WHOQOL-BREF puntuación media que la población general, probablemente por una combinación de estrés, la salud y los factores de ingreso de los hogares. Estas conclusiones deben tenerse en cuenta en la formulación de políticas para proporcionar medidas de mayor apoyo e intervenciones más específicas para los psiquiatras infanto-juveniles y Neuropediatras.

The present study is based on World Health Organization´s quality of life (WHOQOL-BREF) scale to examine quality of life of child and adolescent psychiatrists and child neurologists in Chile, and the factors contributing to their quality of life. Structured interviews were conducted with 79 practitioners. Self-evaluation of their quality of life revealed that 72 percent considered it good or very good, while 58 percent were pleased of very pleased with regards to health satisfaction. The mean scores obtained in each domain of WHOQOL-BREF were: physical capacity (PC) 15.11 +- 2.55, psychological well-being (PW) 15.22 +-2.08, social relationship (SR) 14.63 +- 2.75 and environment (EN) 15.04 +- 2.39. Finally, multiple stepwise regressions were conducted to examine the characteristics of the practitioners which more likely explained the WHOQOL-BREF mean scores. The study found that marital status was significantly correlated to psychological well-being and environment; religion was significantly correlated to the environment; and the number of work places with physical capacity and quality of life score. The results highlights that child and adolescent psychiatrists and child neurologists display a higher WHOQOL-BREF mean score than the general population however, in certain domains the scores are lower, probably due to a combination of stress and health factors. These finding must be taken into account in policy making to provide better and more specific supports and interventions for the child and adolescent psychiatrists and child neurologists.

Entrevistas de evolução psiquiátricas: entre a "Doença Mental" e a medicalização / Psychiatric progress interviews: between the "Mental Illness" and the medicalization

Este trabalho objetivou investigar as concepções implícitas acerca da loucura e de sua cura nas perguntas realizadas por psiquiatras, nas consultas de evolução. O trabalho de campo realizou-se no setor de internação de um hospital psiquiátrico público. Ao todo, foram observadas 88 consultas, realizadas por 4 psiquiatras do hospital, 2 homens e 2 mulheres. Os dados apontam para a presença de uma noção reificada da loucura como doença mental, cujos traços concretos seriam os sintomas mentais listados nos principais compêndios psiquiátricos, DSM e CID, bem como para uma crença na cura como a supressão de tais sintomas. O medicamento apareceu como a principal solução e sua prescrição como a forma privilegiada de tratamento.

The present study aimed to investigate the implicit conceptions related to insanity and its treatment in the questions conducted by psychiatrists in the progress visits. The fieldwork was performed in the hospitalization sector of a public psychiatric hospital. A total of 88 visits conducted by 4 psychiatrists of the hospital - 2 men and 2 women - were observed. The data indicate the presence of a reified notion of insanity as a mental illness, whose actual traces would be the mental symptoms listed in the major psychiatric books, DSM and ICD, as well as a belief in the healing as a suppression of such symptoms. The drug appeared as the main solution, and its prescription as the preferential treatment method.

¿Cuántos somos? ¿Dónde estamos? ¿Dónde debemos estar? El papel del psiquiatra en México: Análisis preliminar / How many are we? Where are we? Where should we be? The psychiatrist's role in Mexico: Preliminar analysis

The recently modified General Law on Health (Ley General de Salud) establishes in article 74b, section VII, that any individual with mental or behavioral disorders will have <

Una de las limitantes más importantes que explican la diferencia entre las personas que necesitan servicios de salud mental y las que acceden a éstos, es el insuficiente número de psiquiatras. La media mundial de psiquiatras por cada 100 000 habitantes es de 3.96 (DE 5.94), la distribución de psiquiatras varía de una región a otra; existe un promedio de 0.06 en los países de bajos ingresos y de 9.0 en los de altos ingresos. La psiquiatría, como especialidad médica, es relativamente reciente. Es hasta el siglo XIX cuando el tratamiento de los trastornos mentales empieza a ser objeto de una especialidad médica. En México, la enseñanza de la psiquiatría como especialidad independiente se inicia en 1950. En 2010 se abrieron 137 plazas para la realización de la residencia en psiquiatría en diferentes partes de la República Mexicana. A pesar de esto, el número de psiquiatras es insuficiente además de que el ámbito de su actividad no corresponde a las recomendaciones de la Organización Mundial de la Salud. El objetivo del presente trabajo fue determinar el número y la distribución de los psiquiatras en la República Mexicana y proponer nuevos campos de acción del psiquiatra. Metodología Se realizó un estudio descriptivo, transversal, heterodémico. Se revisaron las siguientes fuentes de información: el Directorio de la Asociación Psiquiátrica Mexicana (APM) de 2008, el Directorio del Consejo Mexicano de Psiquiatría (CMP) de 2008, el Censo de 1990 y el II Conteo de Población y Vivienda 2005. Resultados En el Directorio de la Asociación Psiquiátrica Mexicana se encontraron 1 397 socios activos. En el Directorio del Consejo Mexicano de Psiquiatría están anotados 1430 psiquiatras certificados. En los últimos 20 años hubo un incremento de psiquiatras del 29%, pues pasaron de 1 108 a 1 430. Para el 2005 la población aumentó de 81.2 a 103.3 millones de personas, es decir hubo un incremento del 27%. Esto indica que la cantidad de psiquiatras se ha mantenido constante respecto al número de habitantes. Observamos que, en total, hay más psiquiatras certificados que miembros de la APM. En cuanto al segundo objetivo, a excepción del Distrito Federal, en el resto del país el número de psiquiatras por número de habitantes es notablemente inferior a la media mundial de 3.96/100 000 habitantes. En promedio, hay 1.3 psiquiatras/100 000 habitantes. En 22 Estados hay menos de un psiquiatra/100 000 habitantes. No se identificó ningún psiquiatra adscrito al primer nivel de atención y casi la mitad estaba adscrita a hospitales psiquiátricos. Conclusiones En México el número de psiquiatras es insuficiente para atender las necesidades de la población por lo que la opción es, como ha propuesto la OMS, reestructurar la atención a los trastornos mentales. En el modelo propuesto se establece un continuo desde la atención que se proporciona directamente en la comunidad, hasta la que se proporciona en los llamados centros de <

Rol del médico psiquiatra según equipos de salud mental comunitaria Servicio de Salud Metropolitano Oriente (SSMO) / Psychiatrist's Role as MentalHealth Teams S. S. M. O

Se presenta la evolución de la práctica médica del psiquiatra, según cambios del enfoque de la psiquiatría y del sistema de servicios de salud, en que esta labor se ha desarrollado. La psiquiatría, como una práctica biopsicosocial, se ve continuamente afectada por los cambios enunciados, que determinan el desempeño real del psiquiatra y las expectativas de este rol, tanto del equipo de salud mental como de los usuarios, en el sector público. En base a que existen escasos estudios empíricos sobre lo que ocurre en la realidad práctica del psiquiatra, a nivel de salud mental comunitaria, se presenta este estudio exploratorio, sobre la percepción de los distintos profesionales acerca del trabajo del psiquiatra: visión del rol real, rol deseado y las competencias valoradas por los equipos, para la buena práctica psiquiátrica.

It is presented the evolution of medical practice of the psychiatrist, according to changes in approach to psychiatry and health care system, that this work has been conducted. Psychiatry, as a biopsychosocial practice, is continually affected by the changes set forth, which determine the actual performance of the psychiatrist and the expectations of this role, both mental health team and users in the public sector. On the basis that there are few empirical studies about what happens in actual psychiatrist’s practiced at, community mental health level, this exploratory study presents the perception of the different professionals about the work of psychiatrist: real vision of the role, expectations of it, and skills valued by the teams for a good psychiatric practice.

Factores psicosociales y laborales asociados al burnout de psiquiatras en Colombia / Psychosocial and work factors associated with burnout in Colombian psychiatrists

Introducción: El burnout es una consecuencia del estrés laboral crónico. Sus efectos negativos pueden afectar no sólo el bienestar de los médicos, sino la calidad del cuidado brindado a sus pacientes. Además de ser un problema de salud pública, también puede ser un obstáculo para lograr un buen funcionamiento institucional. Por estos motivos, es necesario fortalecer la investigación sobre burnout en nuestro medio. Método: Se seleccionaron siete participantes de dos grupos de psiquiatras (alto frente a bajo burnout). Con cada participante se realizó una entrevista semiestructurada, que fue grabada y trascrita. Las trascripciones se analizaron utilizando la metodología de análisis de casos para investigación cualitativa. Resultados: Este estudio recalca la importancia de los modelos de esfuerzo-recompensa y de demandacontrol para el estudio del burnout en psiquiatras. Se observó que el desequilibrio entre los componentes del modelo está dado por factores personales como el sobrecompromiso con el trabajo, factores interpersonales y factores organizacionales. Conclusiones: Altos niveles de burnout en los psiquiatras pueden tener un impacto en el trabajo con sus pacientes. Esto significa que la mejor forma de mejorar la satisfacción de los pacientes es mejorar el bienestar y la satisfacción de los psiquiatras. Por este motivo, además de las consideraciones personales, la prevención del burnout debe hacerse desde políticas gremiales que permitan modificar algunas formas de trabajo presentes en las instituciones...

Introduction: Burnout IS a consequence of chronic work stress. The negative consequence of stress can affect not only the well-being of THE PHYSICIANS but also the quality of care they give to their patients. Besides being a public health problem, it may also be an obstacle to the smooth running of the institution. As such, it is important to strengthen the research on burnout in our environment. Method: Seven participants were selected from each group of psychiatrists (high versus low burnout). An interview based on a semistructured questionnaire was carried out with each participant. The interviews were recorded and transcribed verbatim. The transcriptions were analyzed by using a case study approach for qualitative analysis. Results: As regards the analysis of the interviews, this study emphasizes the importance of the Effort-Reward and Demand-Control models for the study of burnout in psychiatrists. It WAS observed that the imbalance between the model components is caused by individual factors such as overcommittment with work, interpersonal factors and organizational factors. Conclusions: High levels of burnout in psychiatrists may have an impact on their effectiveness when working with patients. This means that the best way to improve the patients’ satisfaction, is to improve the welfare and satisfaction of the psychiatrists. For this reason, apart from personal considerations, prevention of burnout should be carried out based on profession policies with the aim of modifying some of the current work forms in the institutions...

The Situation of Psychiatrists'Job Burnout and its Inspiration to Education of Psychiatry / 中华医学教育探索杂志

Objective: To analyze the influential factors of job burnout among psychiatrists.Methods: Psychiatirsts were evaluated by questionnaires.Results: In general,the job burnout of psychiatrists was very serious.There were significant differences in gender in burnout individual level;the person of 31-35 age was prone to job burnout,and the middle-aged staffs’ job burnout was comparatively in high level;There was significantly correlated show between psychiatrists job burnout level and social support.Besides,there was significantly correlated show between psychiatrists job burnout level and coping way.Conclusion: Psychiatrists Burnout is a high-risk population.To better enhance the stability of their profession,we need concern psychiatrists’mental health from the integrated perspective,and improve their level of social support constantly,and prevent occupational burnout from the perspective of medical education early.