Síndrome del impostor y sus factores asociados en estudiantes de Medicina de seis facultades peruanas

Objetivo: Determinar los factores asociados con el síndrome del impostor (IP) en estudiantes de Medicina de 6 facultades peruanas. Material y métodos: Estudio multicéntrico transversal analítico realizado en estudiantes del primer al sexto año en 6 regiones peruanas. Se incluyeron características sociodemográficas, académicas y psicológicas mediante la escala de depresión, ansiedad y estrés, la escala de autoestima de Rosenberg y la escala del Fenómeno del Impostor de Clance. Los modelos lineales generalizados se construyeron mediante razones de prevalencia estimada brutas y ajustadas. Resultados: De 2.231 estudiantes de Medicina, el 54,3% eran mujeres y el 30,6% padecía IP. Se encontró asociación entre el IP y la depresión (RPa = 1,51; IC95%, 1,27-1,79), la ansiedad (RPa = 2,25; IC95%, 1,75-2,90), el estrés (RPa = 1,37; IC95%, 1,19-1,57) y el sexo mujer (RPa = 1,12; IC95%, 1,01-1,26). Conclusiones: De cada 10 estudiantes de Medicina, 3 sufren IP; tener depresión, ansiedad o estrés, ser mujer y/o cursar el cuarto anno fueron los factores predisponentes.

Objective: To determine the factors associated with impostor syndrome in medical students from six regions of Peru. Material and methods: A multicentre, cross-sectional study was conduced on students from first to the sixth year in six Peruvian regions. Sociodemographic, academic, and psychological characteristics were included through the Depression, Anxiety, and Stress Scale-21, the Rosenberg Self-Esteem Scale and the Clance Imposter Phenomenon Scale. Generalized linear models were performed using crude and adjusted estimated prevalence ratios. Results: Of 2,231 medical students, 54.3% were female and 30.6% had the impostor phenomenon. An association was found between the PI and those who suffered from depression (aPR=1.51; 95%CI, 1.27-1.79), anxiety (aPR = 2.25; 95%CI, 1.75-2.90), stress (aPR=1.37; 95%CI, 1.19-1.57), and being female (aPR = 1.12; 95%CI, 1.01-1.26). Conclusions: Three out of 10 medical students suffer from PI; having some level of depression, anxiety, stress, being a woman, and/or attending the fourth academic year were predisposing factors for their development.

Reacciones al estrés y aspectos psicoterapéuticos / Reactions to Stress and Psychotherapeutic Aspects

Resumen El periodismo científico de este artículo versa sobre una excepción habitual en el ambiente especializado, acerca de diversos trastornos mentales (TM) asociados al estrés y su comorbilidad, inadecuado enfrentamiento por el paciente/familia, su condición genético-epigenética y el deficiente manejo brindado de algunos profesionales de la salud. El desdén del manejo psicoterapéutico (prejuicio-impreparación) dificulta la atención adecuada de los casos. Se insta a desarrollar apego maternofilial apropiado, medidas para el logro de la salud mental social y programas asistenciales para atender los casos.

Abstract The scientific journalism of this article deals with a common exception in the specialized environment about various mental disorders associated with stress and its comorbidity, inadequate confrontation by the patient/family, its genetic-epigenetic condition and the deficient management provided by some health professionals. The disdain of psychotherapeutic management (prejudice- lack of preparation) hinders the adequate attention of cases. It is of the utmost importance to develop proper maternal and filial attachment, adequate measures for the achievement of social mental health and assistance programs to attend the cases.

Depresión en adultos mayores en el Perú: distribución geoespacial y factores asociados según ENDES 2018 - 2020 / Depression in elderly in Peru: geospatial distribution and associated factors according to ENDES 2018 - 2020

RESUMEN Introducción. La depresión en la población adulta mayor es un asunto de salud pública y escasos estudios analizan su distribución según áreas geográficas. Objetivos. Describir la distribución geoespacial y factores asociados del síndrome depresivo (SD) en adultos mayores peruanos según la ENDES 2018 al 2020. Métodos. Estudio transversal y de tipo analítico a partir de los datos de las encuestas nacionales, las cuales emplearon la escala PHQ-9 para medir el SD. Se utilizó la prueba Chi cuadrado de Pearson, regresión logística multivariada y OR con un p valor <0,05. Resultados. La prevalencia del SD en el año 2018 fue de 12,9%; 13,3% en 2019 y 10,8% en 2020. Los factores asociados al SD fueron: ser mujer, vivir en la pobreza. Bajo nivel de instrucción, residir en el área rural, proceder de la sierra y selva, vivir solo y tener 75 o más años de edad. El análisis geoespacial evidenció que el SD se concentra en departamentos de la sierra como Huancavelica, Puno, Ayacucho, Apurímac y por el norte, Ancash y Cajamarca. Conclusiones. Las políticas públicas dirigidas a la reducción del SD deben focalizarse en las mujeres, mayores de 75 años, quienes viven en área rural y fundamentalmente a los que viven en los departamentos identificados con la mayor prevalencia.

ABSTRACT Introduction. Depression in the elderly population is a public health issue and few studies analyze its distribution according to geographic areas. Objectives. To describe the geospatial distribution and associated factors of depressive syndrome (DS) in Peruvian older adults according to ENDES 2018 to 2020. Methods. Crosssectional and analytical study based on data from national surveys, which used the PHQ-9 scale to measure DS. The analysis used Pearson's Chi square test and multivariate logistic regression and OR with p < 0,05. Results. The prevalence of DS in 2018 was 12.9%; 13.3% in 2019 and 10.8% in 2020. The factors associated with DS were: being a woman, living in poverty, having secondary education, residing in rural areas, coming from the mountains and jungle, living alone and being 75 years of age or older. The geospatial analysis shows that the SD is concentrated in five departments: the coast (Lima, La Libertad, Piura) and the southern highlands (Puno, Arequipa). Conclusions. Public policies aimed at reducing DS should focus on women, older than 75 years and those who live in rural areas and fundamentally those who live in the departments identified as having the highest prevalence.

Presença de sintomas depressivos em estudantes de medicina de Buenos Aires/Argentina / Presence of depressive symptoms in medical students from Buenos Aires/Argentina

A depressão é um transtorno mental frequente e vários estudos mostram que os estudantes de medicina são mais suscetíveis. O objetivo deste trabalho foi verificar a presença de sintomas depressivos em estudantes de medicina da Universidade Abierta Interamericana, Buenos Aires. Foi utilizada a pesquisa científica descritiva e transversal em que o Inventário de Depressão de Beck foi utilizado. A normalidade dos dados foi avaliada com o teste de Kolmogórov-Smirnov e os dados foram comparados com o teste T de Student e o teste U de Mann Whitney. As variáveis qualitativas foram comparadas com o teste exato de Fisher. Não houve diferença significativa em idades, níveis de depressão entre homens e mulheres e na distribuição das frequências do ano estudado. O nível leve foi o mais frequente. Os alunos que vivem com amigos têm uma taxa de depressão moderada menor, e os alunos que vivem em hostel têm um índice mais alto. A porcentagem de alunos que nunca fizeram tratamento psicológico é próxima daqueles que nunca receberam tratamento psiquiátrico (AU)

Depression is a frequent mental disorder and several studies show that medical students are more susceptible. The objective was to verify the presence of depressive symptoms among medical students of the Universidad Abierta Interamericana, Buenos Aires. This is a descriptive and crosssectional scientific study using Beck's Inventory of Depression. Data normality was evaluated using the Kolmogorov-Smirnov test and data were compared with Student's T test and Mann-Whitney U test. Qualitative variables were compared with the exact test of Fisher. There was no significant difference in age and depression levels between men and women. There were also no differences in the distribution of the absolute and relative frequencies of the year studied. The mild level was the most frequent. Students living with friends had a lower rate of moderate depression, and students living in hostel presented a higher index of this level. The percentage of students who have never had psychological treatment is very close to those who never perform psychiatric treatment (AU)

Transtorno de adaptação decorrente do parto: avaliação de sinais e sintomas em puérperas / Adjustment disorder resulting from childbirth: evaluation of signs and symptoms in postpartum women

Estudo transversal analítico, que objetivou avaliar a presença de sinais e sintomas de Transtorno de Adaptação em puérperas de uma maternidade pública do Recife, bem como, evidenciar fatores relacionados a este transtorno. Para a coleta de dados foram utilizados dois instrumentos: um sobre dados sociodemográficos e a Escala de Impacto de Eventos. Das 151 puérperas pesquisadas, 12 (7,94%) apresentaram escore compatível com a presença de sinais e sintomas de Transtorno de Adaptação decorrentes do parto, estando associados principalmente a: presença de sentimento de tristeza e desinteresse pela vida anteriores ao parto, via de parto final não desejada, ausência de acompanhante durante o parto, relato de nenhum ou pouco planejamento de gestação, cesárea ou parto vaginal com episiotomia como tipo de parto atual, e assistência prestada pelo profissional médico. Verificou-se que o uso da Escala de Impacto de Eventos pode contribuir na triagem, acompanhamento e suporte adequado das puérperas identificadas com indícios de Transtorno de Adaptação.

This is an analytical cross-sectional study aimed to evaluate the presence of signs and symptoms of Adjustment Disorder in postpartum women in a public maternity hospital in Recife, as well as to discuss factors related to this disorder. Data were collected using two instruments: one for sociodemographic information and the Impact of Events Scale. Of the 151 women in the postpartum surveyed in this study, 12 (7.94%) scored positive for signs and symptoms of Adjustment Disorder resulting from childbirth. These signs and symptoms were chiefly associated with feelings of sadness and disinterest in life prior to delivery, undesired route of delivery, absence of companion during delivery, unplanned or minimally planned pregnancy, cesarean section or vaginal delivery with episiotomy as the current form of childbirth and quality of care provided by the medical professional. It was found that the use of Impact of Events Scale can help screen, monitor and support postpartum women with signs of Adjustment Disorder.

Prevalencia de Sintomatología Depresiva en estudiantes de Medicina de la Universidad de Caldas, Manizales - Colombia / Prevalence of depression symptoms in medical students of the medical program from the University of Caldas, Manizales-Colombia

Introducción: actualmente se entiende que las reacciones de inadaptación a estresores psicosociales identificables ocurren dentro de un corto tiempo después de la aparición del estresor. Ellas se manifiestan a través del daño en el funcionamiento social y ocupacional o a través de síntomas (depresión, ansiedad, etc.), que son excesivos en comparación con una reacción normal y esperada al estímulo. La formación en el pregrado de medicina se asocia a diversas tensiones en los estudiantes; esto tiene implicaciones importantes que se extienden más allá de la educación médica, impactando de manera negativa en el desempeño académico y profesional. Materiales y métodos: este es un estudio descriptivo de corte transversal, la muestra fue de 132 estudiantes del programa de medicina de la Universidad de Caldas, inscritos en el segundo semestre del 2013, seleccionados aleatoriamente, a quienes se les aplicó la escala Beck I para depresión. Se clasificó según la severidad y la presencia de sintomatología depresiva, se obtuvieron datos sociodemográficos, se realizó un análisis de asociación entre los factores como: estrato socioeconómico, sexo, edad, actividad laboral, lugar de procedencia, entre otros. Resultados: de la muestra de 132 estudiantes evaluados, se encontró en 30 de ellos sintomatología depresiva, con una prevalencia global de 22,7%. No hubo asociación estadísticamente significativa con factores demográfico. Se encontró en 23 personas(76,6%), criterios para depresión mínima, 4 (13,3%) para depresión leve, 3 (10%) para depresión moderada y ninguno cumplió criterios de depresión grave. El tercer semestre tuvo la mayor prevalencia de depresión. Conclusión: la sintomatología depresiva en estudiantes de medicina de la Universidad de Caldas es prevalente y se asocia a muchos factores de la vida cotidiana. Este estudio podría ser el punto de partida para la implementación de programas de atención en salud mental a la población médica estudiantil y así lograr un impacto en esta población. Se requieren estudios de mejor diseño para confirmar y seguir los hallazgos aquí expuestos.

Introduction: actually, it isunderstood that maladjustment reactions to subjected psychosocial stressors occur in a short time after the apparition of the stressor. They manifest through the occupational and social functioning damage or through the symptoms (anxiety, depression, etc.) which are excessively compared with a normal and expected reaction to the stressor. The medicine formation is associated to diverse tensions in the students. This has important implications that extends beyond the medical education impacting in a negative way on the academic and professional development. Methodology: this is a descriptive, cross study, the sample was of 132 medical students enrolled in the second trimester of the 2013, randomized, to which was applied the Beck depression scale, them were classified according to depressive symptomatology and severity, in the same way sociodemographic data was obtained, it was made an association analyses between factors like: economic stratum, sex, age, work activity, living further away from home, and others. Results: from the sample of 132 students, it was found that 30 of them presented depressive symptomatology with a global prevalence of 22,7%. There was no statistical significance regarding the associated factors to the depressive symptomatology. It was founded that from this surveyed, 23 (76, 6%) presented minimum depression, 4 (13,3%) to mild depression, 3 (10%) to moderate depression and anyone (0%) presented severe depression. The bigger depression prevalence was found in third semester Conclusion: the depressive symptomatology in medical students of the University of Caldas is prevalent and is associated to many daily life factors to the students, this study could be the starting point for the implementation of mental health programs to the medical students and achieve a positive impact in the students that suffer the depressive symptomatology. It is necessary to realize more studies to confirm and follow the findings presented.

Depresión y factores asociados en la población peruana adulta mayor según la ENDES 2014-2015 / Depression and associated factors in the Peruvian elderly population according to ENDES 2014-2015

Objetivos: Estimar la prevalencia y los factores asociados a la depresión en la población peruana adulta mayor según los resultados de la Encuesta Demográfica y de Salud Familiar (ENDES) 2014-2015. Diseño: Estudio observacional, transversal y analítico. Institucion: UNMSM. Participantes: Adultos mayores. Intervenciones: Muestra probabilística de 11 411 adultos mayores que respondieron a la ENDES 2014-2015. Principales Medidas de Resultados: Prevalencias, promedios, desviaciones estándar y cálculos de OR con un IC 95%. Resultados: La prevalencia estimada fue de 14%. Respecto a los factores de riesgo para la depresión, se identificaron la condición de mujer [OR 1,92 (1,72 2,15)]; ser mayor de 75 años [OR 1,56 (1,40 1,74)]; el carecer de instrucción [OR 2,63 (2,35 2,95)]; el vivir sin pareja [OR 1,32 (1,19 1,47)]; el residir en área rural [OR 2,12 (1,91 2,36)]; el ser pobre [OR 2,30 (2,06 2,56)] y el tener alguna discapacidad [OR 2,63 (2,29 3,02)]. Conclusiones: La prevalencia de depresión en adultos mayores es sustancial. Los factores de riesgo identificados para la presencia de depresión en el adulto mayor, fueron la condición de mujer, ser mayor de 75 años, la carencia de instrucción, el vivir sin pareja, vivir en área rural, la pobreza y la discapacidad física.

Objectives: The study aims to estimate the prevalence and associated factors of depression in the peruvian older adults using the results of the Demographic and Family Health Survey 2014-2015 (ENDES). Design: The study was observational, transversal and analytic. Institution: UNMSM. Participants: Olders adults. Interventions: Probabilistic sample of 11411 older adults who participated in the ENDES 2014-2015. Main Outcomes: Prevalence estimates, means, standard deviations and OR with 95% confidence probability and p-values. Results: Depression prevalence was estimated as 14%. Identified risk factors for depression were being female [OR 1.92 (1.72 2.15)]; being ≥ 75 years old (OR 1.56 (1.40 1.74)]; lack of education (OR 2.63 (2.35 2.95)]; living without a couple [OR 1.32 (1.19 1.45)]; living in rural areas [OR 2.12 (1.90 2.36)]; being poor [OR 2.30 (2.06 2.56)] and having physical disabilities. Conclusions: Depression prevalence in peruvian older adults is substantial. Risk factors were being female, being older, lacking education, living without a couple, living in rural areas, poverty, and physical disabilities.

Level of anxiety versus self-care in the preoperative and postoperative periods of total laryngectomy patients / Nível de ansiedade versus autocuidado no pré-operatório e pós-operatório do paciente laringectomizado total / Nivel de ansiedad versus autocuidados en el preoperatorio y postoperatorio del paciente con laringectomía total

Abstract Objective: estimate the prevalence of anxiety in laryngectomy patients in the pre and postoperative periods and its relation with the self-care level. Method: observational research of 40 patients with stage IV laryngeal cancer. Three observations took place: in the preoperative phase, at seven and at 14 days after the surgery; between June 2010 and December 2012. Two self-care levels were defined: self-sufficient and needing help for activities of daily living and treatment-related activities. To assess the anxiety levels, Zigmond's hospital anxiety scale (1983) was used. Results: in the preoperative and postoperative phases, the patients presented high levels of anxiety. Concerning self-care, on average, self-sufficient patients presented lower levels of anxiety than patients who needed help to accomplish activities of daily living and activities deriving from the surgery, without significant differences. Conclusion: anxiety is present at all times in laryngectomy patients and the reduction of the self-care deficit seems to decrease it, without putting a permanent end to it.

Resumo Objetivo: estimar a prevalência de ansiedade do paciente laringectomizado no pré-operatório e pós-operatório e sua relação com o nível de autocuidado. Método: pesquisa observacional de 40 pacientes com câncer da laringe estágio IV. Foram realizadas 3 observações: no pré-operatório, a 7 e 14 dias pós-operatório, no período de junho de 2010 a dezembro de 2012. Dois níveis de autocuidado foram definidos: autossuficientes e precisar ajuda para as atividades da vida diária e relacionadas ao tratamento. Para avaliar a ansiedade, foi utilizada a escala de ansiedade hospitalar de Zigmond (1983). Resultados: no pré-operatório e pós-operatório, os pacientes apresentaram níveis elevados de ansiedade. Com relação ao autocuidado, os pacientes autossuficientes apresentaram na média níveis inferiores de ansiedades que os pacientes que precisavam de ajuda para realizar as atividades da vida diária y as derivadas da cirurgia, sem chegar a ser significativas estas diferenças. Conclusão: a ansiedade está presente a todo momento no paciente laringectomizado e a diminuição do déficit de autocuidados parece diminuí-la sem acabar definitivamente com ela.

Resumen Objetivo: estimar la prevalencia de ansiedad del paciente laringectomizado, en el preoperatorio y postoperatorio y su relación con el nivel de autocuidados. Método: investigación observacional de 40 pacientes con cáncer de laringe estadio IV. Se realizaron 3 observaciones: en el preoperatorio, a los 7 y 14 días del postoperatorio; en el periodo junio 2010 a diciembre de 2012. Se definieron dos niveles de autocuidados: autosuficientes y necesitar ayuda para las actividades de la vida diaria y derivadas del tratamiento; para evaluar la ansiedad se utilizó la escala de ansiedad hospitalaria de Zigmond (1983). Resultados: en el preoperatorio y postoperatorio los pacientes presentaron niveles elevados de ansiedad. En relación a los autocuidados, los pacientes autosuficientes presentaron en media niveles más bajos de ansiedad que los pacientes que necesitaban ayuda para realizar las actividades de la vida diaria y las derivadas de la cirugía, sin llegar a ser significativas estas diferencias Conclusión: la ansiedad está presente en todo momento en el paciente con laringectomia y la disminución del déficit de autocuidados parece disminuirla sin terminar definitivamente con ella.

Characteristics of Adjustment Disorder Patients as Suicidal Attempters Visited Emergency Department: Significance of Adjustment Disorder and Suicide

PURPOSE: The aim of the current study was to examine the characteristics of suicidal attempters who visited the emergency department (ED) with a psychiatric diagnosis of adjustment disorder. METHODS: Suicidal attempters who had visited the ED were retrospectively selected between January 2015 and December 2015. Sex, age, marital status, psychiatric diagnosis, causes of suicidal attempt, methods of suicidal attempt, influence of alcohol, and results of ED management were reviewed in the medical records. RESULTS: A total of 468 suicide attempters who had visited the ED were interviewed by psychiatrists, and 323 cases were included. Adjustment disorder is the most common diagnosis among these patients (N=202, 62.5%). There was no statistical difference between the adjustment disorder group and the non-adjustment disorder group with respect to marital status, psychiatric diagnosis, causes of suicidal attempt, methods of suicidal attempt, and results of ED management. The number of patients under the influence of alcohol who visited the ED was higher in the adjustment disorder group (p=0.04). CONCLUSION: Adjustment disorder is the most common diagnosis among suicidal attempters who visit the ED. Suicidal attempt in the adjustment disorder group is likely an impulsive decision, but their admission results are just as poor as the non-adjust disorder group.

Comparison of Memory Function and MMPI-2 Profile between Post-traumatic Stress Disorder and Adjustment Disorder after a Traffic Accident

OBJECTIVE: Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD. METHODS: Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered. RESULTS: There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group. CONCLUSION: Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD.

Síntomas de depresión, ansiedad y estrés en estudiantes de odontología: prevalencia y factores relacionados / Symptoms of Depression, Anxiety and Stress Among Dental Students: Prevalence and Related Factors

Objetivos: Estimar la asociación entre síntomas depresivos, ansiosos y de estrés con factores sociodemográficos, académicos y sociales entre estudiantes de odontología. Métodos: Estudio transversal realizado con estudiantes de odontología de una universidad de Cartagena, seleccionados por muestreo aleatorio simple, quienes respondieron a un cuestionario anónimo autoaplicable de 20 preguntas, que incluy ó características sociodemográficas, depresión, ansiedad y estrés (escala DASS 21), función familiar (APGAR familiar) y otros factores asociados con el contexto académico, económico y social. Los datos se analizaron a partir de proporciones y la asociación se obtuvo por razones de disparidad y regresión logística nominal. Resultados: La prevalencia de síntomas ansiosos, depresivos y de estrés fueron del 37,4, el 56,6 y el 45,4 % respectivamente. Los factores asociados a los síntomas depresivos fueron falta de apoyo de amigos (odds ratio [OR ] = 6,2; intervalo de confianza del 95 % [IC95 %], 2,6-14,5), disfunción familiar (OR = 3,6; IC95 %, 1,9-6,6) y dificultades económicas (OR = 2,2; IC95 %, 1,2-3,9 ). Los asociados a síntomas ansiosos fueron la disfuncionalidad familiar (OR = 3,1; IC95 %, 1,8-5,3) y falta de apoyo de amigos (OR = 2,1; IC95 %, 1,1-5,8). Asimismo, para los síntomas de estrés, los factores disfunción familiar (OR = 2,3; IC95 %, 1,4-4,1), ingresos económicos (OR = 2,4; IC95 %, 1,2-4,9 ) y tiempo para descansar (OR = 2,3; IC95 %, 1,4-4,0). Conclusiones: Entre los estudiantes de odontología hay altas prevalencias de síntomas ansiosos, depresivos y de estrés. Los factores asociados son los recursos económicos, la función familiar, la falta de tiempo para el descanso y el apoyo social.

Objectives: To estimate the relationship between depressive symptoms, anxiety and stress and socio-demographic, academic and social factors among dental students. Methods: A cross-sectional study was carried out on dental students from a university in Cartagena, selected by simple random sampling. Students answered a self-report anonymous questionnaire of 20 questions that included demographic characteristics, depression, anxiety and stress symptoms (DASS scale 21), family function (APGAR family) and other factors associated with the academic, economic and social context. Data were analyzed computing odds ratios by binomial logistic regression. Results: The prevalence of symptoms of anxiety, depression and stress were 37.4 %, 56.6 % and 45.4 %, respectively. Factors associated with depressive symptoms were lack of support from friends (OR =6.2; 95 %CI, 2.6-14.5), family dysfunction (OR =3.6; 95 %CI, 1.9-6.6) and economic hardship (OR =2.2; 95 %CI, 1.2-3.9 ). The anxiety symptoms were associated with family dysfunction (OR =3.1; 95 %CI, 1.8-5.3) and lack of support from friends (OR =2.1; 95 %CI, 1.1-5.8). Also for symptoms of stress factors family dysfunction (OR =2.3; 95 %CI, 1.4-4.1), income (OR =2.4; 95 %CI, 1.2-4.9 ) and time to rest (OR =2.3; 95 %CI, 1.4-4.0). Conclusions: Dental students report a high prevalence of symptoms of anxiety, depression and stress. Associated factors are economic resources, family function, lack of time for rest, and social support.

Adjustment disorders in the postpartum resulting from childbirth: a descriptive and exploratory study

Introduction: The experience of childbirth may result in the appearance of adjustment disorders (AD), jeopardizing maternal and newborn health. Aim: Check for signs of AD in mothers and their possible relationship with the birth experience. Method: This is a descriptive exploratory study. Data were collected at two moments in time: in the immediate postpartum period and between 90 to 180 days after delivery, in which we applied the Impact of Events Scale (IES). The study population consisted of 98 mothers at a hospital in São Paulo. Results: Of the 98 women, 9.2% reported signs of AD related to the childbirth experience. This was more common in those who have had c-sections and in those who were not accompanied by a companion. Conclusions: The use of IES allowed us to check for signs of AD, its association with the type of delivery, and with the presence of a companion.

Síndrome de Burnout en estudiantes de odontología de una universidad peruana / Burnouts syndrome in dental students of a peruvian university

Objetivo. Determinar la prevalencia del síndrome de Burnout (SB) en estudiantes de odontología. Material y métodos. El estudio fue de tipo observacional,descriptivo y transversal. La muestra estuvo conformada por 140 alumnos de Periodoncia I matriculados en el IV ciclo de la facultad de odontología de la universidad de San Martín de Porres, durante el segundo semestre académico del 2011. El SB fue medido mediante el Maslach Burnout Inventory Student Survey (MBI-SS) de Schaufeli W et al. (2002). Se realizó el análisis descriptivo de cada variable mediante tablas de distribución de frecuencias; para evaluar la relación entre el SB y los factores asociados se empleó la prueba Chi cuadrado. Resultados.Se encontró que el 45,0% presentó un nivel alto de agotamiento emocional, el 41,4% un nivel alto de cinismo y el 45,7% presentó un nivel bajo de eficacia académica. El 30,7% de la muestra presentó SB en grado severo, y el 23,6% en grado moderado. Se encontró que la prevalencia del SB era significativamente mayor en hombres (P:0,044) y menor en el grupo que vive solo (P:0,036). No se encontró relación entre el SB y el estado civil (P:0.506), trabajar además de estudiar (P:0,722), practicar alguna religión (P:0,912) o deporte (P:0,264), o presentar molestias fisiológicas durante la época de estudios (P:0,229). Respecto a las molestias fisiológicas reportadas por los alumnos durante su época de estudios, se encontró que 114 (81,4%) presentan sintomatología músculo-esquelética, 118 (84,3%) de tipo psicosomáticas, 64 (45,7%) gastrointestinal y 5(3,6%) cardiovascular. Conclusiones. El 30,7% de la muestra presentó SB en grado severo, y el 23,6% en grado moderado. Se encontró que la prevalencia del SB era significativamente mayor en hombres, y menor en el grupo que vive solo. No se encontró relación entre el SB y el estado civil, trabajar además de estudiar, practicar alguna religión o deporte, o presentar molestias fisiológicas durante la época de estudios.

Objective. To determine the prevalence of Burnout Syndrome (BS) in dental students. Material and methods. The study was observational, descriptive and transversal. The sample consisted of 140 students of Periodontology I enrolled in the fourth cycle of the Faculty of Dentistry at the University of San Martin de Porres, during the second semester of 2011. The BS was measured using the Maslach Burnout Inventory - Student Survey (MBI-SS) W Schaufeli et al. (2002). Descriptive analysis was performed for each variable using frequency distribution tables, to evaluate the relationship between BS and associated factors were usedChi-square test. Results. We found that 45, 0% had a high level of emotional exhaustion, 41,4% a high level of cynicism and 45,7% had a low level of academic efficiency. 30, 7% of the sample showed severe BS degree, and 23,6% in moderate degree. It was found that the prevalence of BS was significantly higher in men(P:0.044), and lower in the group who lives alone (P:0.036). No relationship was found between the BS and marital status (P:0.506), to work beside studying(P:0.722), to practice any religion (P:0.912) or sport (P:0.264), or present physiological discomfort during the study (P:0.229). Regarding physiological discomfort reported by the students during their time of study, found that 114 (81,4%) had musculoskeletal symptoms, 118 (84,3%) of psychosomatic type, 64 (45,7%) gastrointestinal and 5 (3,6%) cardiovascular. Conclusions. 30, 7% of the sample showed severe degree of BS, and 23,6% in moderate degree. It was found that theprevalence of BS was significantly higher in men, and lower in the group who lives alone. No relationship was found between the BS and marital status, to work besides studying, practice any religion or sports, or have physiological discomfort during the time of study.

Role of protein O-linked N-acetyl-glucosamine modification in glutamine-induced improvement in vascular hyporeactivity in rats with septic shock / 中华麻醉学杂志

Objective To investigate the role of protein O-linked N-acetyl-glucosamine (O-GlcNAc) modification in glutamine-induced improvement in the vascular hyporeactivity in rats with septic shock.Methods Thirty-two adult male Sprague-Dawley rats,aged 2-3 months,weighing 250-300 g,were randomly divided into 4 groups (n =8 each):sham operation group (S group); septic shock group (C group); glutamine group (G group) ; alloxan group (A group).Septic shock was induced by cecal ligation and puncture (CLP).In G and A groups,glutamine 0.75 g/kg was infused intravenously over 30 min at 1 h before CLP,and in addition alloxan 90 mg/kg was infused intraperitoneally in A group.Phenylephrine (PE) 0.5,1.0,2.0,and 2.5 μg/kg was injected intravenously at 20 min intervals at 6 h after CLP and the percentage increase in mean arterial pressure (MAP) was calculated.The thoracic aorta rings were isolated to perform the isolated vascular tension experiment.The concentration-response curve of PE was obtained in tension experiments,and the PE maximum efficacy (Emas) and median effective dose ( EC50 ) were calculated.The expression of O-GlcNAc modification and iNOS content in the thoracic aorta were detected in all groups.Blood samples were taken to determine the serum concentration of NO.Results Compared with S group,the percentage increase in MAP and Emax were significantly decreased,while the EC50,serum concentration of NO,and expression of O-GlcNAc modification and iNOS content in thoracic aorta were significantly increased in C,G and A groups ( P ＜ 0.05).Compared with C group,the expression of O-GlcNAc modification in the thoracic aorta was significantly increased,and EC50 was significantly decreased in G group,and the percentage increase in MAP and Emax were significantly increased,while the serum concentration of NO,and content of iNOS in the thoracic aorta were significantly decreased in G and A groups ( P ＜ 0.05).Compared with G group,the EC50,serum concentration of NO,and content of iNOS in the thoracic aorta were significantly increased,while the percentage increase in MAP,Emax and expression of O-GlcNAc modification in the thoracic aorta were significantly decreased ( P ＜ 0.05 ).Conclusion Glutamine improves the vascular hyporeactivity through increasing the level of protein O-GlcNAc modification in rats with septic shock.

Estudo sobre depressão reativa e depressão secundária em pacientes após acidente vascular encefálico / Study on reactive and secondary depression in patients following a stroke

O Acidente Vascular Encefálico (AVE) é uma das patologias que mais acarreta comorbidades e alterações incapacitantes, tanto em relação a aspectos físicos, como em relação a aspectos cognitivos e afetivoemocionais. Após a ocorrência do AVE, freqüentemente o quadro dedepressão encontra-se associado. Os tipos mais freqüentes que podemocorrer são depressão reativa e depressão secundária a lesão encefálica.O manejo terapêutico do profissional de Psicologia é fundamental para o tratamento da depressão, sendo reativa ou secundária, interferindodiretamente no processo de reabilitação após o AVE. A presente pesquisa consiste em identificar, na literatura, os sintomas da depressão reativa e secundária em pacientes após AVE e qual a aplicabilidade da avaliação psicológica diferencial no contexto de reabilitação.

A stroke (EVA) is one of the pathologies that cause the most comorbiditiesand damage, not only in physical aspects, but also in cognitive and affective aspects. After a stroke an associated depressive disorder frequently sets in. The most frequent kinds are Reactive Depression and Depression secondary to the brain lesion. The psychologist’s therapeutic management is essential for the treatment of depression, both Reactive and Secondary, intervening directly in the process of rehabilitation after the stroke. The purpose of this study was to identify, in the literature, the symptoms of Reactive Depression and Secondary Depression in post-stroke patients and also the applicability of psychological differential evaluation in this rehabilitation context.

Different decade-feature of military personnel' mental maladjustment and its influencing factors / 中华行为医学与脑科学杂志

ObjectiveTo explore the decade-feature of military personnel' mental maladjustment and its influenced factors.MethodsBy random cluster sampling,a total of 10883 military personnel( including army,navy and air-force) were tested by military mental maladjustment scale (MMMS) in three decades (80s' 90s',2000),then employing SPSS 17.0 for data analysis by using ANOVA,LSD multiple-comparison,and stepwise regression analysis.ResultsThe single scores for behavioral disorders( (2.79 ±2.96),(3.42 ± 2.98 ) vs (2.85± 2.93 ) ),affective disorders ( ( 1.50 ± 1.47 ),( 1.76 ± 1.50 ) vs ( 1.51 ± 1.47 ) ),interpersonal relationship( ( 1.78 ± 1.93 ),( 2.44 ± 2.14) vs (2.30 ± 2.18 ) ),environmental adjustment( (0.63 ± 0.94 ),( 0.89 ± 1.02 )vs ( 1.02 ± 1.18) ),and total score ( ( 6.71 ± 6.01 ),( 8.50 ± 6.20) vs ( 7.69 ± 6.89 ) ) had significant differences in the three decades (P ＜ 0.01 ).The changing disposition of behavior,emotion,interpersonal relationship and total mental maladjustment seemed as reversed V in three decades,but environmental adjustment revealed linear increase; stepwise regression analysis revealed that total scores of mental maladjustment had significant decadeeffect after introducing other four independent variables( t =5.96,P =0.000 ) ; the educational level,urban-rural also had significant influence on military mental maladjustment( t =- 3.15,- 9.02,P =0.002 ～ 0.000 ).ConclusionThe mental maladjustment of military personnel reveale a decreasing disposition from 80s',90s' of last century to the year of 2000 ; the influencing factors are decade,educational level and rural-urban.

Avaliação da depressão em pacientes com lesão medular / Evaluation of depression in patients with spinal cord injury

Estudos contradizem a crença de que toda pessoa com lesão medular sofre de depressão. Para dimensionar o problema e subsidiar intervenções clínicas em contextos de reabilitação, investigouse o nível de depressão por meio do "Inventário Beck de Depressão" em 125 pacientes lesados medulares internados em hospitais de reabilitação; com idade entre 17 e 63 anos. Destes, 36,8 por cento apresentaram depressão moderada a grave e 35,2 por cento, leve a moderada. Não houve diferenças significativas quanto ao nível de depressão, tempo e tipo de lesão. Além da depressão, constataramse diversas reações emocionais em diferentes pacientes com sequelas semelhantes. Sugere-se investigar a co-morbidade da depressão com outras doenças e desenvolver instrumentos de avaliação que retirem itens com baixo poder discriminativo entre depressão e lesão medular do inventário Beck.

Studies contradict the belief that everyone that has spinal cord injury (SCI) suffers from depression. This study aims to investigate the level of depression in patients with SCI using the Beck Inventory of Depression with the aim of assessing the scale of the problem and providing clinical intervention in the context of rehabilitation. The inventory was applied to 125 SCI inpatients, between 17 and 63 yearsold, being treated in a rehabilitation hospital. Of these, 36.8 percent suffered moderate to severe depression and 35.2 percent experienced mild to moderate depression. There was no significant difference in terms of the level of depression, the type of lesion and the duration. In addition to depression, a variety of emotional reactions were observed in different patients with similar sequelae. Research should be conducted to investigate the comorbidity of depression with other illnesses and develop instruments to evaluate depression that eliminate items with low discriminative ability between depression and SCI in the Beck inventory.

The Role of COOP/WONCA Charts in Predicting Psychological Distress in Patients with Medically Unexplained Symptoms and Doctor-shopping Behavior / General Medicine

BACKGROUND: Prior research indicates that patients with medically unexplained symptoms and doctorshopping behavior are more likely to have psychological distress. In patients with somatic symptoms, we hypothesized that high scores on COOP/WONCA Functional Assessment Charts, in addition to the presence of medically unexplained symptoms and doctor-shopping behavior, might have an important role in diagnosing psychological distress.<BR>METHODS: Between November 2002 and March 2003, the patients who presented themselves to the hospital for the first time with somatic symptoms were enrolled in this study. In this study, we defined psychological distress as disease conditions, including Mood disorders, Anxiety disorders, Adjustment disorders, and Somatoform disorders, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV) . Symptoms that, in the doctor's judgment, could not be medically explained were regarded as medically unexplained symptoms. Doctor shopping was defined as those patients with a complaint of sustained and unsolved symptoms for more than one month who had visited two or more medical facilities prior to visiting our hospital and arrived without any physician's referral.<BR>RESULTS: One hundred and six patients out of 496 were diagnosed as having psychological distress. Among these 106 patients, 49 (46.2%) had doctorshopping behavior, 86 (81.1%) had medically unexplained symptoms, and 95 (89.6%) showed high scores on COOP/WONCA charts. Odds ratios and 95% confidence intervals of medically unexplained symptoms and doctor shopping were 24.12 (11.91-48.84) and 4.18 (2.16-8.07), respectively. High scores on COOP/WONCA charts 2, 3 and 6 were significantly associated with the presence of psychological distress, and the odds ratios (95% confidence intervals) of these three items were 1.41 (1.01-1.98), 1.41 (1.02-1.94), and 2.88 (1.68-4.95), respectively.<BR>Positive and negative likelihood ratios for 4 items (i.e., age of not less than 45 years; duration of symptoms of not less than 6 months, ; doctorshopping behavior; and, medically unexplained symptoms) were 1.16 and 0.85; 1.43 and 0.55; 3.16 and 0.63; and, 3.96 and 0.24, respectively. Positive and negative likelihood ratios for high scores on COOP/WONCA charts were 1.42 and 0.28. Under ROC curves for the diagnosis of psychological distress, the information of COOP/WONCA charts, in addition to that of clinical data, medically unexplained symptoms, and doctor shopping behavior, increased the accuracy in diagnosing psychological distress.<BR>CONCLUSIONS: In patients with somatic symptoms, COOP/WONCA charts increased diagnostic accuracy in predicting psychological distress when patients showed sustained symptoms for more than 6 month, doctor shopping, and medically unexplained symptoms.

Psychological obstacle in peacekeeping officers and soldiers and intervention study / 解放军医学杂志

Peacekeeping is a military operation under certain conditions.In the special operations,the military personnel will have a special emotional response,mainly tension.It includes physical and psychological stress,based on the cognition and evaluation of the environment and forms of military activities.The psychological problems of peacekeepers caused by peacekeeping operation have been identified as one of the major reasons for non-combat attrition.Thus,researches on mental health of peacekeepers should not be ignored.So,we reviewed the interaction between peacekeeping operations and peacekeepers'mental health,and a few psychological intervention techniques to provide theoretical and practical basis for serving peacekeepers with mental health.

Investigation and analysis of correlated factors on mental health of peacekeeping forces in Liberia dispatched from Pakistan and Bangladesh / 解放军医学杂志

Objective To investigate the status and influential factors of mental health of Pakistani and Bangladeshi peacekeeping forces in Liberia.Methods By random sampling,300peacekeeping officers and soldiers dispatched from Pakistan and Bangladesh(150 each)in Liberia were investigated with Chinese Military Mental Health Scale(CMMHS),Military Mental Maladjustment Scale(MMMS) and Social Support Rating Scale(SSRS),and they were carried out for two times on the 7th day and the 120th day after arrival in peacekeeping mission area.Results The total score and each factor score of CMMHS(except for obsessive-compulsive,anxiety and interpersonal sensitivity)and the total score of MMMS of the peacekeepers at the 7th day after their arrival in mission area were significantly higher than those at the 120th day(P