Discussion on the Social Return after the Outbreak of COVID -19 / 中国医学伦理学

After COVID -19, patients, medical workers and the whole society in COVID -19 were faced with the challenge of how to quickly return to normal life. Patients cured in COVID -19 would face mental or psychological barriers, or be discriminated against, or face problems such as overweight of local epidemic prevention policies. The front-line medical personnel experienced job burnout and a variety of mental and psychological disorders, with some even developing physical symptoms. During the epidemic, ordinary people were in a state of psychological stress, education, production and economic activities were affected, and the incidence of mental or psychological disorders increases. It was necessary to provide COVID -19 patients with mental health monitoring and counseling. Give professional guidance to front-line medical staff, arrange rotation reasonably, and pay attention to their mental health status. Local governments should strictly implement the national epidemic prevention system, formulate epidemic prevention policies with humanistic care, actively publicize epidemic related knowledge and safeguard the rights and interests of the people.

Psychiatric Symptoms in Women with High-risk Pregnancy in the Postpartum Period: A Case-control Study

Abstract Objective: Psychiatric symptoms are common mental issues in pregnancy and the postpartum period. There is limited information regarding the psychiatric symptoms of women with high-risk pregnancy in the postpartum period. This study aimed to compare the severity of psychiatric symptoms and psychological distress in women with high-risk and low-risk pregnancies in the postpartum period. Methods: This case-control study examined 250 women in the postpartum period in two groups with low-risk (n = 112) and high-risk (n = 138) pregnancies. Women completed the Brief Symptom Inventory-53 (BSI-53) and the Risk Postnatal Psychosocial Depression Risk Questionnaire (PPDRQ). Results: The mean severity of psychiatric symptoms in women with high-risk pregnancies was significantly higher than that in women with low-risk pregnancies (39.34 ± 17.51 vs. 30.26 ± 17.08). Additionally, the frequency of psychological distress in women with high-risk pregnancies was approximately twice higher than that in women with low-risk pregnancies (30.3% vs. 15.2%). Furthermore, the risk factors for depression in women with high-risk pregnancies were almost 1.5 times (59.8% vs. 39.8%) higher than the factors in women with low-risk pregnancies. The results of the logistic analysis indicated that high-risk pregnancies could be twice the odds ratio of developing postpartum psychological distress (ß = 2.14, 95% CI 1.4-6.3, p= 0.036). Conclusion: Psychiatric symptoms and the psychological distress index are higher in postpartum women with high-risk pregnancies than in postpartum women with low-risk pregnancies. The study suggests that obstetricians and pregnant women's health care providers should strongly consider screening of psychiatric symptoms in women with high-risk pregnancies both during pregnancy and after delivery as the women's routine care priorities.

Soledad y ansiedad durante el confinamiento por COVID-19. El efecto mediador de la regulación emocional / Loneliness and anxiety during COVID-19 lockdown. The mediating effect of emotion regulation

Resumen El confinamiento ocasionado por la pandemia del COVID-19 ha impactado en la vida de los estudiantes universitarios en todo el mundo. Conocer sus efectos en la salud mental y el comportamiento será una prioridad en los siguientes años. En este contexto, el objetivo de la presente investigación fue analizar por primera vez las relaciones directas e indirectas entre la experiencia de soledad, las estrategias de regulación emocional desadaptativas (rumiación, evitación, supresión, catastrofización y autoculpa) y la ansiedad en una muestra de universitarios mexicanos. Con base en él, se hipotetizó que las estrategias de regulación emocional desadaptativas mediarían la relación entre la soledad y la ansiedad. Para lograr este propósito se especificó un modelo de ecuaciones estructurales. Un total de 824 estudiantes universitarios participaron en la presente investigación. Los resultados mostraron que los datos se ajustaron de manera adecuada al modelo estructural especificado. Por otra parte, también se encontró que la soledad tuvo un efecto directo que no fue estadísticamente significativo con la ansiedad. En conclusión, estos hallazgos revelan la presencia de un efecto de mediación al mostrar que la soledad estuvo relacionada indirectamente con la ansiedad por su relación con las estrategias de regulación emocional desadaptativas. Con ello, al analizar la función mediadora de las estrategias de regulación emocional desadaptativas se aportaron, por primera vez en México, nuevos elementos que permiten conocer con mayor profundidad los efectos directos e indirectos de estos tres constructos.

Abstract The lockdown caused by the COVID-19 pandemic has impacted the lives of undergraduate students around the world. Knowing its effects on mental health and behavior will be a priority for years to come. Due to the multiple negative effects that confinement by the COVID-19 pandemic has brought, this study aims to provide new scientific evidence that will allow a better understanding of the effects of the experience of loneliness caused by this pandemic. Based on the procedural model of emotion regulation created by Gross, the objective of this research was to analyze the direct and indirect relations between the experience of loneliness, maladaptive emotion regulation strategies (rumination, avoidance, suppression, catastrophizing, and self-blame) and anxiety in a sample of Mexican undergraduate students. Based on this goal, it was hypothesized that maladaptive emotion regulation strategies would mediate the relation between loneliness and anxiety. To achieve this purpose, a total of 824 undergraduate students participated in the present research. In addition to providing their sociodemographic data, they answered the De Jong Gierveld Loneliness Scale, the Emotion Regulation Questionnaire, the Cognitive-Behavioral Avoidance Scale, the Cognitive Emotion Regulation Questionnaire, and the Beck Anxiety Inventory. In order to carry out the mediating analysis, a structural equation model was created which included three latent variables (loneliness, maladaptive emotion regulation strategies and anxiety). This model was tested using the Lavaan software. The indirect effects were analyzed using the bootstrapping method. The results showed that maladaptive emotional regulation strategies had a mediating role which was positive and significant in the relation between loneliness and anxiety. Regarding the measurement model, confirmatory factor analysis was used to test the measurement model comprising the three latent variables. Results showed that the measurement model fit the observed data appropriately. Furthermore, with the purpose of examining the validity of the measurement model, the average variance extracted and square root of the average variance extracted were calculated. Findings indicated that the average variance extracted for each construct was higher than all the squared correlations involving that construct. This confirmed the discriminant validity of all variables of study. Regarding the structural model, results showed acceptable data fit. The model explained 48 % of the variance in anxiety. The structural equation analysis revealed that loneliness was related positively with maladaptive emotion regulation strategies. Similarly, maladaptive emotion regulation strategies were associated positively with anxiety. Likewise, it was possible to confirm the main hypothesis of this study which stated that maladaptive emotion regulation strategies would mediate the influence of loneliness on anxiety among Mexican university students. Finally, it was confirmed that loneliness had a nonsignificant direct effect on anxiety. Regarding the contribution of each of the five maladaptive emotion regulation strategies, rumination had a significant function in the mediating process showing that loneliness had an impact on anxiety via the continuous thoughts that participants had about their own emotions. In turn, because of the strategy of catastrophizing, participants intensified their thoughts and emotions waiting for the worse scenario which in turn increased their levels of anxiety. Likewise, the strategies of avoidance and suppression had also a significant contribution on the mediating role of maladaptive strategies. Finally, the strategy of self-blame was a significant contribution to the mediating function. Therefore, with the purpose of controlling emotions associated with loneliness, it was possible that participants could blame themselves as a mechanism to regulate their emotions. In conclusion, these findings reveal the presence of a mediating effect by showing that loneliness was indirectly related to anxiety via its relation with maladaptive emotion regulation strategies.

Estados emocionales y estrategias de afrontamiento frecuentes en consulta para parejas infértiles / Emotional states and frequent coping strategies in the medical consultation for infertile couples / Estados emocionais frequentes e estratégias de enfrentamento em consulta para casais inférteis

RESUMEN Introducción: La infertilidad se conoce como la imposibilidad de concebir un hijo de forma natural o de llevar un embarazo a término, luego de un año de vida sexual activa. Por cuanto la procreación es un acontecimiento vital, no lograrla puede generar algunos trastornos psicológicos. Objetivo: Identificar los estados emocionales negativos, así como el estilo de afrontamiento utilizados por ambos miembros de parejas infértiles durante su tratamiento, en la consulta municipal de infertilidad del Policlínico Comunitario "30 de Noviembre", de Santiago de Cuba, durante el periodo enero de 2020 a febrero de 2021. Método: Se realizó un estudio descriptivo con una muestra intencional de 85 parejas (n꓿85) que asistieron a dicha consulta. Se utilizó el método clínico, se revisaron las historias clínicas de los pacientes y se aplicaron técnicas psicológicas (Inventario de Ansiedad Rasgo-Estado de Ch. Spielberger, inventario de depresión de Beck y escala de afrontamiento de Lazarus). Resultados: Predominó el nivel alto de ansiedad como estado en el 61,18 % de los hombres y en el 68,24 % de las mujeres, no se encontró ningún miembro de las parejas infértiles que presentara niveles bajos de ansiedad, además, se constataron niveles severos de depresión en el 52,94 % de las mujeres y en el 44,71 % de los hombres. Predominó el modo de afrontamiento centrado en las emociones en el 90,59 % de la muestra estudiada. Conclusiones: La ansiedad y la depresión, así como la carencia de estrategias de afrontamiento eficaces son fenómenos psicológicos presentes en las parejas que asisten a la consulta municipal de infertilidad.

ABSTRACT Introduction: Infertility is define by the failure to conceive a child naturally or achieve a pregnancy after one year of a sexually active life. Therefore, procreation is a vital aspect in humans, and fail to achieve it may generate some psychological disorders. Objective: To identify the negative emotional states, as well as the coping style used by both members of infertile couples during their treatment in the municipal fertility department at the Policlínico Comunitario "30 de Noviembre", Santiago de Cuba, during the period January 2020 to February 2021. Method: A descriptive study was conducted with a purposive sample of 85 couples (n꓿85) who attended such consultation. Method: a descriptive study was conducted with a purposive sample of 85 couples (n꓿85) who attended such consultation. It was used the clinical method, clinical histories were reviewed and various psychological techniques were applied (Ch. Spielberger's Trait-State Anxiety Inventory, Beck's depression inventory and Lazarus' coping scale). Results: High level of anxiety predominated in both sex, in male (61.18%) and in female (68.24%), with no member of the infertile couples showing up low levels of anxiety. In addition, severe levels of depression were found in 52.94% of women and 44.71% of men. The emotion-focused coping mode predominated in 90.59% of the studied sample. Conclusions: Anxiety and depression, as well as lack of effective coping strategies are psychological phenomena shows in couples attending the municipal fertility department.

RESUMO Introdução: A infertilidade é conhecida como a incapacidade de conceber um filho naturalmente ou de levar uma gravidez a termo, após um ano de vida sexual ativa. Como a procriação é um evento vital, sua não realização pode gerar alguns transtornos psicológicos. Objetivo: Identificar os estados emocionais negativos, bem como o estilo de enfrentamento utilizado por ambos os membros de casais inférteis durante seu tratamento, na consulta municipal de infertilidade da Policlínica Comunitária "30 de Noviembre", em Santiago de Cuba, no período de janeiro 2020 a fevereiro de 2021. Método: Foi realizado um estudo descritivo com uma amostra intencional de 85 casais (n꓿85) que compareceram à referida consulta. O método clínico foi utilizado, os prontuários dos pacientes foram revisados e as técnicas psicológicas foram aplicadas (Inventário de Ansiedade Traço-Estado de Ch. Spielberger, inventário de depressão de Beck e escala de enfrentamento de Lazarus). Resultados: O alto nível de ansiedade prevaleceu como estado em 61,18% dos homens e em 68,24% das mulheres, nenhum membro dos casais inférteis apresentou níveis baixos de ansiedade, além disso, foram encontrados níveis graves de depressão em 52,94% das mulheres e 44,71% dos homens. O modo de enfrentamento focado na emoção prevaleceu em 90,59% da amostra estudada. Conclusões: A ansiedade e a depressão, bem como a falta de estratégias de enfrentamento eficazes, são fenômenos psicológicos presentes em casais que frequentam o ambulatório municipal de infertilidade.

Effect of Personality Characteristics on Near-term Postoperative Mental Health of Male Patients with Laryngeal Squamous Cell Carcinoma / 肿瘤防治研究

Objective To investigate the effect of personality characteristics on near-term postoperative mental health of patients with laryngeal squamous cell carcinoma (LSCC). Methods We included 119 patients with LSCC who underwent surgical treatment. The recent psychological state was assessed by SCL-90, SAS and SDS 5 to 7 days after surgery. The EPQ was used to evaluate the personality characteristics of patients after operation. Multiple linear stepwise regression method was used to analyze the influencing factors of SAS and SDS scores of LSCC patients. Results The postoperative scores of SCL-90, SAS and SDS of LSCC patients were significantly higher than the Chinese norm (P≤0.05). The scores of P scale and N scale in EPQ were higher than the domestic norm (P < 0.01). The scores of somatization, obsessiveness, anxiety, depression, hostility, phobia, paranoia and psychosis were significantly higher than the Chinese norm (P < 0.05). Family income, surgical method, postoperative radiochemotherapy, psychoticism and neuroticism personalities were the influencing factors of postoperative SAS score (P < 0.01). Family income, surgical method, postoperative radiochemotherapy, neurotic personality were the influencing factors of postoperative SDS score (P < 0.01). Conclusion LSCC patients have near-term depression, anxiety and other psychological disorders after operation. In terms of personality, they have psychoticism and neuroticism. Family income, surgical methods, postoperative radiochemotherapy, psychoticism and neuroticism are independent risk factors affecting postoperative SAS and SDS scores.

Alteraciones psicológicas en niños y adolescentes durante confinamiento social por COVID- 19. Policlínico René Vallejo Ortiz / Psychological alterations in children and adolescents during social confinement by COVID-19. René Vallejo Ortiz Polyclinic / Alterações psicológicas em crianças e adolescentes durante o confinamento social por COVID-19. René Vallejo Ortiz Policlínica

RESUMEN La pandemia COVID-19 es una emergencia sanitaria a nivel global, en este contexto es necesario subrayar que niños, niñas y adolescentes es un grupo vulnerable; ellos están expuestos a los graves efectos físicos, emocionales y psicológicos producto del confinamiento prolongado. Se realizó un estudio descriptivo, retrospectivo y transversal con el objetivo de analizar las alteraciones psicológicas en niños y adolescentes durante el confinamiento social por COVID-19, que asistieron a consultas de Psiquiatría infantil pertenecientes al Policlínico universitario René Vallejo Ortiz en el periodo del 23 abril a 30 de junio 2020. El universo de estudio quedó constituido por 73 pacientes mientras la muestra fueron 33 niños y adolescentes con cuadros psicológicos agudos a partir del mes de haberse orientado el confinamiento social. Se estudiaron variables como: edad, sexo, manifestaciones clínicas más frecuentes según edad y sexo, factores predisponentes y funcionamiento familiar. Durante el confinamiento por COVID-19 se determinó en la población estudiada la relación entre los estados afectivos emocionales negativos, alteraciones del comportamiento, factores de riesgos asociados y familias disfuncionales.

ABSTRACT The COVID-19 pandemic is a global health emergency, in this context it is necessary to underline that children and adolescents are a vulnerable group; they are exposed to the serious physical, emotional and psychological effects of prolonged confinement. A descriptive, retrospective and cross-sectional study was carried out with the objective of analyzing the psychological alterations in children and adolescents during social confinement due to COVID-19, who attended child psychiatry consultations belonging to the René Vallejo Ortiz University Polyclinic in the period of April 23 as of June 30, 2020. The study universe was made up of 73 patients while the sample consisted of 33 children and adolescents with acute psychological conditions from the month of having oriented the social confinement. Variables such as: age, sex, most frequent clinical manifestations according to age and sex, predisposing factors, and family functioning were studied. During confinement for COVID-19, the relationship between negative emotional affective states, behavioral alterations, associated risk factors and dysfunctional families was determined in the studied population.

RESUMO A pandemia COVID-19 é uma emergência global de saúde, neste contexto é necessário sublinhar que as crianças e adolescentes constituem um grupo vulnerável; estão expostosaos graves efeitos físicos, emocionais e psicológicos do confinamento prolongado. Realizou-se estudo descritivo, retrospectivo e transversal como objetivo de analisar as alterações psicológicas em crianças e adolescentes durante o confinamento social devidoao COVID-19, que compareceram a consultas de psiquiatria infantil da Policlínica Universitária René Vallejo Ortiz no período de 23 de abril a 30 de junho de 2020. O universo do estudo foi composto por 73 pacientes en quanto a amostra foi composta por 33 crianças e adolescentes com sintomas psicológicos agudos desde o mês de orientação ao confinamento social. Foram estudadas variáveis ​​como: idade, sexo, manifestações clínicas mais frequentes segundo idade e sexo, fatores predisponentes e funcionamento familiar. Durante o confinamento para COVID-19, a relação entre estados afetivos emocionais negativos, alterações comportamentais, fatores de risco associados e famílias disfuncionais foi determinada napopulação estudada.

Screening and influence of common psychological disorders in the perinatal period / 中国实用护理杂志

With the change of medical model, the impact of common psychological disorders on the occurrence, development and treatment has been paid more attention to. If the diagnosis is not timely, it can result in serious long-term effects on the wellbeing of women, their partners and infants. We reviewed the recent foreign studies on the common psychological problems of perinatal women and summarize the epidemiology, identification and interventions, so as to understand the impact on the offspring. It is of great significance to strengthen the training for health professionals in wider psychosocial assessment and to adopt effective intervention methods to alleviate the adverse psychological state of perinatal women.

Virtual Reality Therapy in Clinical Psychology – a conceptual paper

Virtual reality therapy came into existence in the mainstream of psychology in the last two decades.Virtual reality is a technology, a communication interface, and an artificial experience. VR has nowemerged as the promising tool in many domains of clinical care and research as the capacity of thistechnology creates controllable, multisensory, interactive 3D stimulus offering clinical assessment,intervention and training. Virtual reality therapy is a medium of in-vivo exposure therapy that is unreal butrelies on perceptual stimulation, visual cues, sounds, touch and smell to trigger emotions which is used forintegrating and enhancing actual therapeutic approaches. The unique value of this technology hascontinued to grow and advanced the clinical areas that have long been mired in the methods of the past.The aim of the present study is to emphasize the potential offered by Virtual Reality (VR) in clinicalpsychology and its advances in therapeutic uses, in the treatment of numerous anxiety disorders, sexualdysfunctions and also for children with disabilities, also discussing the clinical rationale

Impact of comorbid psychological disorders on intestinal symptoms in patients with irritable bowel syndrome with diarrhea / 中华消化杂志

Objective To investigate the clinical symptoms and mental state of patients with irritable bowel syndrome with diarrhea (IBS-D ) , and to analyze the characteristics of psychological disorders in patients with IBS-D and their impacts on intestinal symptoms .Methods From July 2009 to June 2012 ,patients met Rome Ⅲ criteria of IBS-D were consecutively enrolled at Peking Union Medical College Hospital .The symptoms of IBS were investigated by IBS symptoms questionnaire and mental state were evaluated by Hamilton anxiety scale (HAMA ) and Hamilton depression scale (HAMD ) . The differences in intestinal symptoms between patients with comorbid psychological disorders and without psychological disorders were compared .And the correlation between the scores of HAMA ,HAMD and intestinal symptoms were analyzed . Two independent sample t-tests ,chi square test and Fisher exact probability were performed for statistical analysis .Spearman rank correlation was used for correlation analysis .Results A total of 231 patients with IBS-D were enrolled .There were 133 males and 98 females with an age of (42 .8 ± 11 .1) years old and a disease course of (4 .5 years (8 .0 years)) .The HAMA and HAMD scores were 17 .00 ± 7 .12 and 14 .05 ± 6 .00 ,respectively ,and 72 .29％ (167/231) patients had comorbid psychological disorders ,32 .90％ (76/231 ) patients had moderate to severe anxiety and/or depression ,mainly had anxiety .The proportion of patients with ordinary abdominal pain or discomfort and the proportion of moderate to severe abdominal pain or discomfort in patients with psychological disorders were higher than those of patients without psychological disorders (53 .29％ , 89/167 vs . 34 .37％ , 22/64;49 .44％ ,44/89 vs .18 .18％ ,4/22) ,and the differences were statistically significant (χ2=6 .634 and 7 .002 , P=0 .010 and 0 .009) .In patients with comorbid psychological disorders ,more patients had frequent onset of abdominal pain or discomfort ,less achieved completely improvement after defecation , and often accompanied with defecation related symptoms .The HAMD score was positively correlated with the onset frequency of IBS (r=0 .172 ,P=0 .009) ,and the HAMA score was positively correlated with the degree of abdominal pain or discomfort before defecation (r=0 .134 , P= 0 .042) .The HAMA and HAMD scores were negatively correlated with the improvement degree of abdominal pain or discomfort after defecation (r= -0 .215 , P=0 .001 ;r= -0 .251 , P<0 .01) ,and were positively correlated with waiting time for symptoms improvement (r=0 .175 , P=0 .008;r=0 .219 , P= 0 .001) .Conclusion Most IBS-D patients have comorbid psychological disorders , anxiety and/or depression greatly impact the intestinal symptoms of patients with IBS .

Diagnosis and Treatment of Patients with Refractory Functional Gastrointestinal Disorders Accompanying with Psychological Disorders / 胃肠病学

Patients who have functional gastrointestinal disorders(FGIDs)often together with psychological disorders and damaged quality of live. Management of FGIDs patients failed to conventional drug therapy,so-called the refractory FGIDs,is a challenge for gastroenterologists. Till now,FGIDs are still not fully recognized and clarified and having only limited therapeutic approaches. In this article,we reviewed the clinical characteristics of refractory FGIDs accompanying with psychological disorders and the progress in research on their diagnosis and treatment for improving the understanding and formularizing the management of this disease.

Psychological disorders and personality characteristics of with gastro-esophageal reflux disease.

Background: Gastro-esophageal reflux disease (GERD) can be traced back to disorders of the gastro-esophageal junction but several psychological factors interact to affect treatment outcomes. There is sparse literature from India regarding psychological co-morbidity and personality characteristics in patients with GERD. Aim and Objectives: To study the co-morbid psychological disorders and personality profiles in patients suffering from GERD. Methods: Two hundred patients with GERD-related symptoms were randomly screened for psychological disorders and personality characteristics using 30-item General Health Questionnaire (GHQ) and Sixteen Personality Factor Questionnaire (16PF) respectively. Patients who screened positive for presence of co-morbid psychological disorders were further interviewed using Structured Clinical Interview for DSM-IV Axis 1 Disorders (SCID-1) to find out the type of psychological disorder. Results: The prevalence of psychological co-morbidity in patients with GERD-related symptoms in our sample was found to be 40%. Major depressive disorder was the most common psychological disorder found co-morbid in these patients. Alcohol dependence was significantly observed in males; while in females, major depressive disorder and generalized anxiety disorder was more commonly seen. Regarding personality characteristics, a higher degree of neuroticism and risk-taking attitudes was found in patients of GERD with associated psychological co-morbidity Conclusions: This study suggests that the management of GERD may include psychological evaluations and possibly interventions in standard treatment protocols.

Perceived Stress, Alexithymia, and Psychological Health as Predictors of Sedative Abuse / 가정의학회지

BACKGROUND: The harmful effects of sedative medications and substances in conjunction with limited research regarding predictive psychological constructs of drug abuse necessitate further investigation of associated factors. Therefore, the present study aimed to elucidate the roles of perceived stress, alexithymia, and psychological health as predictors of sedative abuse in medical students. METHODS: In this cross-sectional study, 548 students at Kermanshah University of Medical Sciences, Iran, were selected using stratified random sampling. The data were obtained using the Perceived Stress Scale, an alexithymia scale (Farsi version of the Toronto Alexithymia Scale-20), and a General Health Questionnaire to assess psychological health. Data were analyzed using discriminant analyses. RESULTS: The results demonstrated that the user and non-user of sedative substances groups had significantly different predictive variables (except for social function disorder) (P>0.05). Physical complaints, alexithymia, and perceived stress, which had standard coefficients of 0.80, 0.60, and -0.27, respectively, predicted sedative drug use. CONCLUSION: The results of the present study indicate that perceived stress, alexithymia, physical complaints, anxiety, and depression are associated with sedative drug abuse.

As vivências de um grupo de pacientes com transtornos alimentares: a relação com o espelho e a imagem corporal / The experiences of a group of patients with eating disorders: the relationship with the mirror and body image / Experiencias de un grupo de pacientes con trastornos de la conducta alimentaria: la relación con el espejo y su imagen corporal / Les expériences d'un groupe de patients atteints de troubles d'alimentation: la relation avec le miroir et l'image corporelle

A incidência de transtorno alimentar (TA) na população vem aumentando progressivamente. Dentre os diferentes problemas relacionados à alimentação, destacam-se a anorexia nervosa (AN) e a bulimia nervosa (BN). O objetivo desta pesquisa é investigar como pacientes atendidos em um ambulatório de saúde mental vivenciaram o aparecimento de sintomas de TA. Foram convidados a participar voluntariamente deste estudo dez pacientes em atendimento junto ao Hospital das Clínicas de uma cidade do oeste paulista. Seis concordaram em participar. Para a coleta de dados, foi utilizada a entrevista semiestruturada. Os depoimentos revelam dois fatores que favoreceram o aparecimento de TA, segundo a ótica das entrevistadas: conflitos em relacionamentos interpessoais e pressão social para emagrecimento/estigmatização. Possivelmente, influências socioculturais permeiam as significações atribuídas pelas pacientes à sua imagem refletida no espelho, contribuindo para o aparecimento de distorções na percepção do peso e forma corporal. Os resultados deste estudo sugerem ainda que, muitas vezes, a tomada de consciência do problema demora a ocorrer. Assim, o envolvimento de familiares e o fornecimento de informações e orientações sobre a natureza do transtorno são essenciais no escopo das intervenções para tratamento do problema. Supõe-se que programas de natureza preventiva, destinados à melhoria do funcionamento interpessoal dos adolescentes, poderiam minimizar o risco do aparecimento de TA. Este estudo pretende contribuir com ações dessa natureza, além de subsidiar equipes multiprofissionais no atendimento aos pacientes.

The incidence of eating disorders (ED) in the population has been increasing steadily. Among the different issues related to food, the highlights are Anorexia Nervosa (AN) and Bulimia Nervosa (BN). The objective of this research is to investigate how patients treated at an outpatient mental health experienced the onset of symptoms of ED. Ten patients in care at the 'Hospital das Clínicas' of the West of São Paulo City were invited to participate, voluntarily in this study,. Six of them agreed to participate. For data collection, we used the semi- structured interview. Reports reveal two factors that favored the appearance of ED, according to the interviewees: conflicts in interpersonal relationships and social pressure for slimming/stigmatization. Possibly, sociocultural influences permeate the meanings attributed by patients to their mirror image, contributing to the emergence of distortions in the perception of body weight and shape. The results of this study also suggest that often the awareness of the problem has a delay to happen. Thus, the involvement of family members and the provision of information and guidance on the nature of the disorder are essential in the scope of interventions for treating the problem. It is assumed that preventive programs aimed at improving interpersonal functioning of adolescents, could minimize the risk of developing ED. This study aims to contribute to such actions, in addition to supporting multiprofessional teams in patient care.

La incidencia de los trastornos de la conducta alimentaria en la población ha crecido en los últimos años. Entre los distintos problemas relacionados con la alimentación destacan la anorexia nerviosa (AN) y la bulimia nerviosa (BN). El objetivo de este estudio es investigar cómo los pacientes atendidos en un ambulatorio de salud mental han experimentado la aparición de síntomas de trastornos de la conducta alimentaria. Diez pacientes del Hospital de las Clínicas de una ciudad del Oeste de São Paulo fueron invitados a participar en este estudio. Seis estuvieron de acuerdo en participar. Para la recogida de datos se utilizó una entrevista semiestructurada. Las respuestas revelan dos factores favorecedores de la aparición de los trastornos de la conducta alimentaria desde la perspectiva de los entrevistados: los conflictos en las relaciones interpersonales y la presión social para la pérdida de peso/estigmatización. Posiblemente las influencias socioculturales impregnan los significados atribuidos por los pacientes a su propia imagen reflejada en el espejo, lo que contribuye a la aparición de distorsiones de la percepción del peso y forma corporal. Los resultados de esta investigación también indican que a menudo la toma de consciencia del problema tarda en ocurrir. Por lo tanto, la participación de los familiares y la entrega de información y orientaciones acerca de la naturaleza del trastorno son esenciales en el alcance de las intervenciones para el tratamiento del problema. Se supone que los programas de prevención dirigidos a mejorar el funcionamiento interpersonal de los adolescentes podrían minimizar el riesgo de aparición de trastornos de la conducta alimentaria. Este estudio tiene como objetivo contribuir a este tipo de acciones, además de apoyar a los equipos multidisciplinarios en la atención a los pacientes.

L'incidence des troubles d'alimentation dans la population augmente progressivement. Entre les différentes questions liées à l'alimentation, on peut démarquer l'anorexie mentale et la boulimie. L'objectif de cette recherche est d'étudier la façon dont les patients traités dans une clinique de santé mentale ont connu l'apparition des symptômes des troubles d'alimentation. Dix patients en soins à l'hôpital das Clinicas dans une ville de Oeste Paulista ont été invités à participer à cette étude. Parmi ces invitations, six personnes ont accepté de participer. Pour la collecte des données, on a utilisé une interview semi-structurée. Les rapports révèlent deux facteurs qui ont favorisé l'apparition des troubles d'alimentation, d'après les patients interrogées: les conflits dans les relations interpersonnelles et la pression sociale pour la perte de poids / stigmatisation. C'est possible que le sens attribué par les patients à sa propre image reflétée dans le miroir soit imbu d'influences socioculturelles, ce qui contribue à la manifestation de distorsions dans la perception du poids et de la forme corporels. Les résultats de cette étude suggèrent également que, parfois, la prise de conscience du problème se produit en retard. Ainsi, la participation des membres de la famille et la fourniture d'informations et des conseils sur la nature de la maladie sont essentiels dans le cadre des soins pour traiter le problème. On présume que les programmes de prévention, visant à améliorer le fonctionnement interpersonnel des adolescents pourraient réduire le risque de l'apparition des troubles de l'alimentation. Cette étude tend à contribuer à ces actions et aussi de soutenir des équipes multidisciplinaires pour soigner les patients.

Aborto y salud mental de la mujer / Aborto e saúde mental da mulher / Abortion and the mental health of women

La existencia o no de alteraciones de la salud mental de la mujer como consecuencia del aborto es algo que suscita en el momento actual un vivo debate, pues, junto a convencidos profesionales que defienden su existencia, otros se manifiestan totalmente opuestos a ello. Para abordar este tema hemos evaluado algunas de las más recientes revisiones que nos han parecido de calidad metodológica contrastada, así como también algunos de los últimos artículos publicados. Podemos concluir que no existe un síndrome posaborto como tal, pero sí trastornos psicológicos secundarios al aborto. Finalmente, reflexionamos sobre en qué medida el sentimiento de culpabilidad que la mujer pueda experimentar por haber abortado podría influir en la presentación o no de trastornos psicológicos tras el acto abortivo.

The existence or the lack of alterations of mental health of women as consequence of abortion currently arises a lively debate, since, while there are convinced professionals defending its existence, others are completely opposed to it. In order to examine this issue we have evaluated some of most recent reviews considering they have contrasted methodological value, as well as some of the latest published articles. We can conclude that there is no post abortion syndrome as such, but there are secondary psychological disorders after abortion. Finally, we reflect about in which extent the feeling of guilt that woman may experiment for having aborted may influence the presentation or not of psychological disorders after the abortion act.

A existência ou não de alterações da saúde mental da mulher como consequência do aborto é algo que suscita no momento atual um vivo debate, pois, junto a convencidos profissionais que defendem a sua existência, outros se manifestam totalmente opostos a isso. Para abordar este tema avaliamos algumas das mais recentes revisões que nos pareceram de qualidade metodológica comprovada, assim como também alguns dos últimos artigos publicados. Podemos concluir que não existe uma síndrome pós-aborto como tal, mas sim transtornos psicológicos secundários ao aborto. Finalmente, refletimos sobre em que medida o sentimento de culpabilidade que a mulher pode experimentar por haver abortado poderia influir na apresentação ou não de transtornos psicológicos após o ato abortivo.

Efeitos da perda rápida de peso em atletas de combate / Effects of rapid weight loss in combat athletes / Efectos de la perda rápida de peso em atletas de combate

Em esportes de combate, a estratégia de perda rápida de peso é frequentemente utilizada com o propósito de obter vantagens sobre o oponente. Nesse processo, a redução de peso é extremamente acentuada com curta duração, o que pode provocar uma série de desordens fisiológicas, psicológicas e também quanto ao desempenho esportivo. Sendo assim, a presente revisão teve como objetivo compilar os principais achados quanto aos efeitos adversos devido à perda rápida de peso, tendo em vista o embasamento científico aos profissionais envolvidos com atletas de combate. Os estudos demonstram um grande número de atletas que se engajam em programas com tal propósito, repetindo inúmeras vezes ao longo da vida. Entretanto, os potenciais riscos à saúde causados por tal prática usualmente não são levados em consideração. Com base nos estudos apresentados, a perda rápida de peso deve ser avaliada cuidadosamente por educadores físicos, médicos, nutricionistas e demais profissionais da área da saúde, considerando os vários efeitos adversos que essa prática pode resultar. É importante ressaltar que a preservação da integridade e do bem-estar dos atletas envolvidos pode ser fator determinante na decisão de um combate.

In combat sports, the rapid weight loss is a strategy often used for the purpose of gaining an advantage over the opponent. In this process, the weight reduction is extremely sharp in a short period of time, which can cause a variety of physiological or psychological disorders, as well as a decreasing on sports performance. Therefore, this review aims to compile the main findings about the adverse effects due to rapid weight loss, in order to give a scientific base for professionals involved with combat athletes. Several studies have shown a large number of athletes who engage in programs for this purpose, repeating this procedure several times throughout life. However, potential risks to health caused by this practice usually are not taken into account. Based on the studies presented, the rapid weight loss should be carefully evaluated by physical educators, physicians, nutritionists and other health care professionals, considering the various adverse effects that this practice can result. It is important to remember that the preservation of the integrity and welfare of the athletes involved may be a determinant factor to decide a combat.

En los deportes de combate, la estrategia de rápida pérdida de peso es a menudo utilizada para el fin de obtener ventajas sobre su oponente. Lo proceso de reducción de peso es muy fuerte con una corta duración, que puede causar una variedad de trastornos fisiológicos, psicológicos, así como para el desempeño deportivo. Por lo tanto, esta revisión pretende recopilar las principales conclusiones sobre los efectos adversos debido a la pérdida rápida de peso, en vista de la base científica para los profesionales que trabajam com atletas de combate. Varios estudios muestran un gran número de atletas que participan en los programas para ese fin, repitiendo varias veces por toda la vida. Sin embargo, los riesgos potenciales para la salud causados por esta práctica no se suele tener en cuenta. Sobre la base de los estudios presentados, la pérdida rápida de peso debe ser evaluado cuidadosamente por los educadores físicos, médicos, nutricionistas y otros profesionales de la salud, teniendo en cuenta los efectos adversos diferentes que esto puede resultar. Es importante destacar que la preservación de la integridad y el bienestar de los atletas que participan pueden ser un factor determinante en la decisión de un concurso.

Social Skills and Psychological Disorders: Converging and Criterion-Related Validity for YSR and IHSA-Del-Prette in Adolescents at Risk / Habilidades sociales y trastornos psicológicos: validez convergente y de criterio para YSR e IHSA- Del-Prette en Adolescentes en riesgo

This study evaluated indexes of converging and criterion-related validity for the Social Skills Inventory for Adolescents (IHSA-Del-Prette) and the Youth Self-Report (YSR) in two samples: one referring to clinical service (CLIN), with 28 adolescents (64.3% boys), 11 through 17 years old (M = 13.75; SD = 1.74), and the other referring to a psycho-educational program (PME = 46.2%), mainly composed ofboys (91.7%) aged 13 through 17 (M = 15.33; SD = 1.47). Both samples completed the two inventories. Results showed a high incidence of psychological disorders in both samples (between 4% and 79% in the borderline or clinical range on YSR scales) and accentuated deficits in the general and subscale scores of IHSA-Del-Prette, especially on the frequency scale (25% to 58%). The correlations between the instruments in the two groups supported criterion-related and converging validity. Some issues concerning the differences between the samples and about the construct of social competence, underlying these inventories, are discussed.

Este estudio evaluó los índices de validez convergente y de criterio para el Social Skills Inventory for Adolescents (IHSA-Del-Prette) y el Youth Self-Report (YSR) en dos muestras: una que fue referida al servicio clínico (CLIN), con 28 adolescentes (64.3% hombres), entre 11 a 17 años de edad (M = 13.75; DE = 1.74), y otra que fue referida a un programa psico-educa-tivo (PME = 46.2%), principalmente compuesto de hombres jóvenes (91.7%) entre los 13 y los 17 años de edad (M = 15.33; DE = 1.47). Las dos muestras completaron los dos inventarios. Los resultados mostraron una alta incidencia de desórdenes psicológicos en ambas muestras (entre 4% y 79% en el límite o rango clínico en las escalas YSR) y déficits acentuados en las puntuaciones generales y subescala de IHSA-Del-Prette, especialmente en la escala de frecuencia (25% a 58%). Las correlaciones entre los instrumentos en los dos grupos apoyaron la validez de criterio y la convergente. Se discuten algunos aspectos que subyacen a estos inventarios relacionados con las diferencias entre las muestras y con respecto al constructo de la competencia social.

Impacto del paso de los huracanes Gustav e Ike en la salud psicológica de un grupo de escolares afectados / Impact of Gustav and Ike hurricanes crossing on the psychological health of a group of affected schoolchildren

OBJETIVOS: evaluar el impacto de los huracanes Gustav e Ike en la salud psicológica de un grupo de escolares. Caracterizar la representación psicológica que de los huracanes tuvieron estos, e identificar la presencia de síntomas psicológicos durante y posterior al paso de los meteoros por la localidad afectada. MÉTODOS: se realizó un estudio de casos clínicos 3 meses después de haber pasado los eventos meteorológicos (noviembre 2008). Se seleccionaron 10 niños con edades entre 7 y 10 años, y se recogió el antecedente de daño parcial o total en sus viviendas. La comunidad escogida para el estudio fue Bacunagua, perteneciente al municipio de Los Palacios, el más afectado en la provincia de Pinar del Río. Los instrumentos utilizados fueron el dibujo libre, la composición con el tema El ciclón y la entrevista, además se realizó una entrevista a los padres, para recoger el comportamiento de los niños durante y después del paso del ciclón. RESULTADOS: se consideraron 3 categorías como representación psicológica, las cuales fueron destrucción, afección emocional y recuperación; y los síntomas identificados fueron la ansiedad y la tristeza, en 2 niños los síntomas fueron suficientes para considerar la posibilidad Trastorno de Adaptación con Sntoma Ansioso-depresivo. CONCLUSIONES: el trabajo nos permitió acercarnos a los efectos psicológicos de los desastres desde técnicas psicológicas proyectivas, y nos mostró las características en tanto representación y sintomatología psicológica que poseían los escolares del meteoro que los afectó, lo cual permitió acercarse al tratamiento pos desastre existente y proponer recomendaciones

OBJECTIVES: to assess the impact of hurricanes Gustav and Ike on the psychological health of a group of schoolchildren. To characterize the psychological representation that hurricanes had on they and to identify the presence of psychological symptoms during and after the passing of meteors by the affected place. METHODS: a study of three clinical cases was conducted three months after the passing of these metereological events (November, 2008). Ten children were selected aged between 7 and 10 and collecting the background of partial damage in their houses. Community selected for study was Bacunagua from the Los Palacios municipality because of this was the more affected one in the Pinar del Río province. The tools used were the free drawing, a composition called The Cyclone and an interview with the children as well as with parents to know the behavior of children during the cyclone passing. RESULTS: authors took into account three categories as psychological representation, which included destruction, emotional affection and recovery and the identified symptoms were enough to consider the possibility of Adaptation Disorder with Impatient-Depressive symptoms. CONCLUSIONS: present paper allowed us an approach to psychological effects of disasters using projective psychological techniques showing the representation features and the psychological symptoms of schoolchildren due to the meteor affecting them and it was possible to come closer to existing post-disaster treatment and to propose the appropriate recommendations

Limitación cognitiva en niños con anemia drepanocítica sin historia de afectación neurológica / Cognitive limitation present in children with drepanocytemia without a neurologic affection history

En los últimos años se comunican dificultades cognitivas en niños con anemia drepanocítica (AD) sin afectación neurológica evidente y se insiste en la necesidad de atención especializada. Se estudiaron 29 pacientes sin ningún elemento recogido en sus historias clínicas que evidenciara afectación del SNC. Se aplicó la escala de inteligencia de Wechsler y se comparó con niños sanos. Se obtuvo información de sus maestros sobre el rendimiento en las asignaturas de Matemática y Español, interés mostrado en clases y disciplina. Se observó disminución en los cocientes de inteligencia (CI) de la escala total (p= 0,014) y de la escala ejecutiva (p= 0,008) y también en las subescalas semejanzas (p= 0,048), ordenar figuras (p= 0,017) y diseño de bloques (p= 0,001). Los maestros consideraron el rendimiento en Matemática (40 %) y Español (36 %) menor que en los demás alumnos. El déficit neurocognitivo esta presente en niños con AD sin historia previa de afectación del SNC, por lo que esta área debe evaluarse periódicamente como parte de su atención integral.

In past years cognitive difficulties are reported in children with drepanocytemia (SCA) without evident neurologic affection, and we emphasized the need of a specialized care. A total of 29 patients were studied without any element evidencing affection of central nervous system (CNS) in registered in their medical records. We applied the Wechsler intelligence scale compared to health children. We get information from their teachers on performance in subjects like Mathematics and Spanish, interest and discipline during the classes. We note a decrease in intelligence quotient (IC) from the total scale (p= 0,014), and from rendition scale (p= 0,008), and also in similarity scales (p= 0,048), to figures array (p= 0,017), and block design (p= 0,001). Professors considered that Mathematics and Spanish performance (40 % and 36 %, respectively) lower than in the other pupils. Neurocognitive deficit is present in children with SCA without a prior history of CNS affection, thus, this area must to be periodically assessed as part of its integral care.

Trastornos psíquicos y psicosomáticos: problemática de salud actual de los docentes mexicanos / Psychological and psychosomatic disorders: a survey of teachers in Mexico

Objetivo: Identificar las exigencias asociadas a problemas psíquicos y psicosomáticos en profesores que laboran en instituciones educativas públicas y privadas del nivel medio superior. Planteamiento del problema: Las condiciones de trabajo que enfrentan actualmente los profesores, han dado lugar a un incremento de trastornos psíquicos y psicosomáticos, dado que el trabajo que realizan es más de tipo intelectual y/o de servicio, con una baja exposición a riesgos laborales y un alto nivel de exigencias que se desprenden de la redistribución de las tareas y competencias laborales, entre otras características inherentes al modo en que el trabajo está organizado. Material y Método: Se realizó un estudio de prevalencia. Participaron 203 profesores de una escuela pública y 105 docentes de seis escuelas particulares. Se aplicó una encuesta individual, con el fin de detectar la relación de exigencias laborales con la presencia de problemas psíquicos y psicosomáticos. Los datos fueron procesados y analizados por medio de un programa computarizado diseñado para este fin. Resultados y conclusiones: Se detectó mayor número de exigencias derivadas de la organización de trabajo en las instituciones privadas, en tanto en la escuela pública, predominaron las exigencias que se desprenden de la infraestructura en la institución. La ansiedad, la depresión, los trastornos del sueño y la cefalea tensional, estuvieron asociados a horarios extensos, supervisión estricta, tareas repetitivas, entre otros. Por lo que es necesario implementar medidas preventivas, para mejorar las condiciones laborales y de salud de los docentes.

Objective: To Identify job demands associated with psychological and psychosomatic disorders among teachers working in public and private high schools in Mexico. Background: The working conditions faced by teachers today place them at an increased risk of psychological and psychosomatic disorders. Their work is more of an intellectual and/or service type, with little exposure to traditional workplace hazards, but there are high demands due to redistribution of job skills and tasks, among other characteristics inherent to the way their jobs are organized. Methods and Materials: A prevalence study was conducted. Study participants consisted of 203 public school teachers and 105 teachers from six private schools. An individual questionnaire was administered in order to explore the relationship between job demands and the presence of psychological and psychosomatic problems. The data were processed and analyzed using a computer program designed for this purpose. Results and conclusions. A greater number of demands arising from the organization of the work was observed among private school teachers. In public schools, demands related to school infrastructure predominated. Anxiety, depression, sleep disorders and tension headaches were associated with long hours, strict supervision, and repetitive tasks, among other factors. This points to the need for greater preventive efforts to improve working conditions and the health of teachers.

Psychological disorders and their effect on the therapeutic efficacy in type 2 diabetes / 中国糖尿病杂志

Objective To investigate the psychological disorders and their effect on the therapeutic efficacy in type 2 diabetes(T2DM).Methods FBG,PBG,HbA1c,TG,CH,urine albumine,urine Cr were tested in 120 T2DM patients(male 51,female 69),simultaneously the psychological status was evaluated with the measuring scales of SDS,SAS,PEI and EPQ.The effect of abnormal psychological status on treatment of type 2 diabetes was analyzed.Results 32.5% patients had depression,and 18.3% had anxiety.The scores of the patients were remarkably higher than those of the controls.The total scores of E,N,P of EPQ were higher and the score of PEI was lower in the patients with T2DM than those in the healthy subjects.Diabetes disease status of the patients with psychological disorders was more severe than that of the patients without abnormal psychology.Conclusions Psychological disorders are common in T2DM patients.The psychological disorders can effect the treatment effect and prognosis of type 2 diabetes.