Pattern of Psychiatric Emergencies in Children and Adolescents at a Tertiary Care Centre After Onset of COVID-19 Pandemic

Objective: To assess changes in profile of psychiatric emergencies in children and adolescents (aged <19 year) during the coronavirus disease 2019 (COVID-19) pandemic compared to pre-pandemic period. Methods: The psychiatric emergency records were analyzed for the period of April, 2019 – September, 2021 to assess the pattern and profile of mental health emergencies in children and adolescents in the period before and after the onset of the pandemic lockdown (i.e., 23 March, 2020). Results: 379 consecutive child and adolescent psychiatric emergencies were identified, of which 219 were seen after the onset of pandemic. Commonest reason for referral in the pandemic group was attempted self-harm (44.3%). The ICD-10 neurotic, stress-related and somatoform disorders constituted the commonest diagnostic category, similar to pre-pandemic period. A significantly higher proportion (44% vs 28%) of children was prescribed benzodiazepines in the pandemic period, compared to the pre-pandemic period. Conclusion: The average monthly psychiatric emergencies in children and adolescents showed no increase during the pandemic period. Self-harm was the commonest cause of psychiatric referral in emergency services mental health crisis in the younger population.

Adolescent depression and resting-state fMRI brain networks: a scoping review of longitudinal studies

The neurobiological factors associated with the emergence of major depressive disorder (MDD) in adolescence are still unclear. Previous cross-sectional studies have documented aberrant connectivity in resting-state functional magnetic resonance imaging (rs-fMRI) networks. However, whether these findings precede MDD onset has not been established. This scoping review mapped key methodological aspects and main findings of longitudinal rs-fMRI studies of MDD in adolescence. Three sets of neuroimaging methods to analyze rs-fMRI data were identified: seed-based analysis, independent component analysis, and network-based approaches. Main findings involved aberrant connectivity within and between the default mode network (DMN), the cognitive control network (CCN), and the salience network (SN). Accordingly, we utilized Menon's (2011) triple-network model for neuropsychiatric disorders to summarize key results. Adolescent MDD was associated with hyperconnectivity within the SN and between DMN and SN, as well as hypoconnectivity within the CCN. These findings suggested that dysfunctional connectivity among the three main large-scale brain networks preceded MDD onset. However, there was high heterogeneity in neuroimaging methods and sampling procedures, which may limit comparisons between studies. Future studies should consider some level of harmonization for clinical instruments and neuroimaging methods.

Efectos de la pandemia por COVID-19 en la salud mental de adolescentes / Effects of the COVID-19 pandemic on adolescent mental health

Objetivo: Analizar los efectos de la pandemia por COVID-19 en la salud mental de adolescentes. Método: Descriptiva documental. Resultados: 15 articulos relacionados al tema de investigación. Conclusión: Mediante el profundo análisis realizado, se puede concluir que, todas las personas se han visto afectadas por la pandemia , sin embargo la población que más sufrió han sido los adolescentes, debido a que han tenido que adaptarse a mecanismo establecidos para frenar el contagio del COVID-19, dejando así a un lado las actividades cotidianas que antes realizaban cómo asistir a clases presencialmente, interactuar con otras personas y concurrir a espacios o eventos públicos ,como consecuencia en el futuro de estos jóvenes se puede generar una serie de trastornos emocionales , puesto que la adolescencia es una etapa fundamental y crucial para el desarrollo de hábitos sociales.

Objective: To analyze the effects of the COVID-19 pandemic on the mental health of adolescents. Method: Descriptive documentary. Results: 15 articles related to the research topic. Conclusion: By means of the deep analysis carried out, it can be concluded that, all people have been affected by the pandemic , however the population that suffered the most has been the adolescents, due to the fact that they have had to adapt to the mechanism established to stop the contagion of COVID-19, thus leaving aside the daily activities that they previously performed how to attend classes in person, interact with other people and attend public spaces or events ,as a result in the future of these young people can generate a series of emotional disorders , since adolescence is a fundamental and crucial stage for the development of social habits

Associations between cyberbullying victimization and depressive symptoms in early adolescence / Associações entre vitimização por cyberbullying e sintomas de depressão em jovens adolescentes

OBJECTIVE: To explore distinctive links between specific depressive symptoms (e.g., anhedonia, ineffectiveness, interpersonal problems, negative mood, and negative self-esteem) and cyberbullying victimization (CBV). METHODS: This cross-sectional study collected data from 268 adolescents between the ages of 13 to 15 years-old (50.7% female) who responded to the Children's Depression Inventory (CDI) and to the Revised Cyberbullying Inventory (RCBI). RESULTS: CBV was positively associated with all CDI's domains (anhedonia, ineffectiveness, interpersonal problems, negative mood, and negative self-esteem). Demographics ­ such as age and gender ­ were not significant in explaining CBV. However, ineffectiveness (B = .46, p = .04) and negative mood (B = .37, p < .05) significantly predicted CBV. CONCLUSION: This study reports the first Brazilian examination of the links existing between CBV and specific types of depressive symptoms. Data reinforce the negative impact of cyberbullying experiences on youth's mental health, highlighting stronger associations between negative mood and CBV, which could inform more tailored interventions.

OBJETIVO: Explorar as associações diferenciais entre sintomas depressivos específicos (anedonia, ineficácia, problemas interpessoais, humor deprimido e autoestima negativa) e vitimização por cyberbullying. MÉTODOS: Trata-se de um estudo quantitativo e transversal que coletou dados de 268 adolescentes, com idades entre 13 e 15 anos (50,7% do sexo feminino), que responderam ao Inventário de Depressão Infantil (CDI) e ao Inventário de Cyberbullying revisado. RESULTADOS: A vitimização por cyberbullying esteve associada positivamente com todos os domínios avaliados pelo CDI (anedonia, ineficácia, problemas interpessoais, humor deprimido e autoestima negativa). Dados demográficos ­ como idade e sexo ­ não se mostraram significativos na predição da vitimização por cyberbullying. Todavia, ineficácia (B = 0,46, p = 0,04) e humor negativo (B = 0,37, p < 0,05) foram preditores significativos da vitimização por cyberbullying. CONCLUSÃO: O estudo apresenta os primeiros resultados empíricos brasileiros associando a vitimização por cyberbullying com sintomas específicos de depressão. Os dados reforçam o impacto negativo das experiências de cyberbullying na saúde mental dos jovens, revelando associações mais robustas entre humor deprimido e vitimização por cyberbullying, o que pode subsidiar ações de tratamento e prevenção.

Continuity of psychiatric disorders between 6 and 11 years of age in the 2004 Pelotas Birth Cohort

Objective: To investigate the incidence and homotypic and heterotypic continuity of psychiatric disorders between ages 6 and 11. Methods: In 2004, all live births in the city of Pelotas, Brazil, were recorded (n=4,231). Psychiatric disorders were assessed by the Strengths and Difficulties Questionnaire (SDQ). SDQ subscale scores (emotional symptoms, conduct problems, hyperactivity/inattention, and peer relationship problems) were categorized as normal or abnormal. To examine associations between problems over time, odds ratios were computed using logistic regression. Results: Any SDQ difficulty was observed in 350 children (10.4%, 95%CI 9.4-11.5) at age 6 and 476 (14.2%, 95%CI 13.0-15.4) at age 11, with a higher prevalence among boys at both ages. Between ages 6 and 11, there was a 50 and a 45% increase in the prevalence of emotional and hyperactivity/inattention symptoms, respectively. Among those who had any SDQ difficulty at age 6, that status persisted in 81% at age 11. We found homotypic continuity of emotional symptoms, conduct problems, hyperactivity/inattention, and peer relationship problems. Conclusions: Our results indicate an increasing incidence of psychiatric disorders in this age group, with rates of disorders and continuity patterns similar to those observed in other studies.

Adolescente con autolesiones no suicidas en un entorno de adversidad psicosocial / Adolescent with non-suicidal self-harm in a psychosocial adversity environment

Las conductas lesivas no suicidas suponen un problema sanitario de creciente importancia, con una prevalencia en muestras comunitarias de adolescentes del 15-20 %. Las autolesiones pueden tener un significado diverso; se clasifican en intrapersonales o interpersonales; son un factor de riesgo y evolutivo, con inicio en la adolescencia temprana. Se presenta el caso de una adolescente de 12 años con factores de riesgo psicosociales, que acudió a la consulta por cortes autoinfligidos en los brazos y las piernas, realizados con una cuchilla de afeitar, detectados en el colegio. Se intervino potenciando la autoestima y en regulación de emociones con intervención multidisciplinar (sistema educativo, servicios sociales, psiquiatría infantojuvenil y pediatría), con una evolución positiva. Es vital su detección y abordaje con el paciente y su familia para evitar riesgos futuros, especialmente, de patología psíquica. La intervención se realiza desde la Atención Primaria, pero precisa la colaboración de otros profesionales.

Non-suicidal harmful behaviors pose a health problem of increasing importance, with a prevalence in community samples of adolescents of 15-20 %. Self-harm can have adverse meaning, qualifying in intrapersonal or interpersonal; they are a risk and evolutionary factor, with an age of onset in early adolescence. We present the case of a 12-year-old adolescent with psychosocial risk factors, who went to the consultation for self-cuts in arms and legs, made with a razor, detected in the school. It was enhanced her self-steem an guided in regulation of emotions with multidisciplinary intervention (educational system, social services, infantile-juvenile Psychiatry and Pediatrics), with a positive evolution. It is vital to detect and approach this issue with the patient and the family to avoid future risks, especially psychic pathology. The intervention is done from Primary Care, but it is necessary the collaboration of other professionals.

Psicanálise e pedopsiquiatria: entre interlocuções e querelas / Psychoanalysis and child and adolescent psychiatry: between dialogues and quarrels / Psychanalyse et pédopsychiatrie: entre interlocutions et querelles

O presente estudo busca identificar as contribuições da parceria e as consequências da separação entre a psicanálise e a pedopsiquiatria. Os conceitos de narcisismo e de autoerotismo foram peças-chave para o surgimento e legitimação da pedopsiquiatria como especialidade médica distinta da psiquiatria do adulto. Em um contexto no qual o discurso psiquiátrico vigente defende um referencial essencialmente empirista em detrimento do diálogo com abordagens psicodinâmicas, verifica-se que a rejeição da psicanálise promove a desnaturação da pedopsiquiatria, já que transtornos mentais infantis são reduzidos a disfunções puramente neurológicas.

The present study seeks to identify the contributions of the partnership between psychoanalysis and Child and Adolescent Psychiatry as well as the consequences of their separation. The concepts of narcissism and autoeroticism were fundamental for the emergence and legitimation of child and adolescent psychiatry as a medical specialty distinct from adult Psychiatry. In a context in which the current psychiatric discourse defends an essentially empiricist base to the detriment of the dialogue with psychodynamic approaches, it is verified that the rejection of psychoanalysis promotes the denaturation of Child and Adolescent Psychiatry, since the child mental illness are reduced to purely neurological dysfunctions.

La présente étude a cherché à identifier les contributions du partenariat entre psychanalyse et pédopsychiatrie ainsi que les conséquences de leur séparation. Les concepts de narcisisme et de autoerotisme ont joué un rôle fondamental pour l'émergence et la legitimation de la pédopsychiatrie en tant que specialité médicale distincte de la psychiatrie de l'adulte. Dans un contexte dans lequel le discours psychiatrique actuel défend un referenciel essentielment empiriste au detriment du dialogue avec les approches psychodynamiques, nous avons vérifié que le rejet de la psychanalyse promeut la dénaturation de la pédopsychiatrie, puisque les maladies mentales infantiles sont réduites à des dysfonctionements purement neurologiques.

Prevalencia de trastornos mentales en menores de edad atendidos en un hospital psiquiátrico departamental / Prevalence of mental disorders in children treated in a public psychiatric hospital

RESUMEN Objetivo Determinar la prevalencia de los trastornos mentales presentados en menores de edad en un hospital psiquiátrico departamental. Método Estudio de prevalencia de periodo. Se empleó una base de datos secundaria suministrada por el Hospital Psiquiátrico Universitario del Valle (HPUV) de Santiago de Cali, proveniente del registro de la historia clínica sistematizada correspondiente al año 2014. La población estuvo conformada por los pacientes menores de edad que consultaron durante el periodo, se utilizó la totalidad de los registros disponibles en la base de datos. Resultados Del total de consultas atendidas se encontró que el 35,7% (755) correspondía al sexo femenino y el 64,3% al masculino (1 361). El principal diagnostico psiquiátrico atendido en esta población fue el episodio depresivo con 11,6% seguido por los trastornos mixtos de la conducta y de las emociones con un 8,5%. Conclusiones La evolución en el tiempo de la salud mental no ha cambiado significativamente. La pasada encuesta nacional de salud mental 2015 presenta resultados similares al encontrado en el presente estudio, particularmente en la región pacífica, donde la depresión y trastornos de conducta son más prevalentes.(AU)

ABSTRACT Objective To determine the prevalence of mental disorders in children treated at a regional psychiatric hospital. Materials and Methods Period prevalence study. A secondary database was supplied by the Hospital Psiquiátrico Universitario del Valle (HPUV) of Santiago de Cali. This database came from the systematized clinical history of the year 2014. The population consisted of underage patients who consulted during the period. All the records available in the database were used. Results Of the total number of children who visited the clinic, 35.7% (755) were females and 64.3% were males (1 361). The main psychiatric diagnosis observed in this population was depressive episode (11.6%), followed by mixed behavioral and emotional disorder (8.5%). Conclusions The evolution of mental health over time has not changed significantly. The 2015 National Mental Health Survey presents similar results to those found in this study, particularly in the Pacific region, where depression and behavioral disorders are more prevalent.(AU)

Caracterización clínica y demográfica de la hospitalización psiquiátrica infantojuvenil en un hospital general

Introducción: Se implementan actualmente nuevos modelos de hospitalización psiquiátrica infantojuvenil, para hacer frente a la creciente demanda de recursos de atención psiquiátrica intensiva requeridos por esta población. Objetivo: Identificar las características clínicas y demográficas de los niños y adolescentes con diagnóstico psiquiátrico hospitalizados en Salas de Pediatría de un Hospital General Pediátrico. Metodología: Estudio descriptivo, retrospectivo de corte transversal, en base a historias clínicas de 180 casos hospitalizados en el periodo enero-agosto del año 2015.Variables: Edad, sexo, procedencia, motivo de ingreso, diagnóstico psiquiátrico, tipo de patología psiquiátrica, medicación, servicio desde el cual se indicó la evaluación psiquiátrica, días de hospitalización, seguimiento y derivación. Resultados: En el periodo de estudio se identificaron 180 pacientes hospitalizados con uno o más diagnósticos psiquiátricos, de los cuales 67.2% eran del sexo femenino. La mediana de la edad fue de 13 años. De un total de 387 diagnósticos constatados, los seis diagnósticos psiquiátricos más frecuentes fueron: los diferentes tipos de maltrato infantil (42,89%), los trastornos depresivos (21,71%), los intentos suicidas (8,27%), el trastorno adaptativo (4,39%) y el trastorno por estrés post traumático (4,13%). El 56% presentó comorbilidad de dos o más diagnósticos psiquiátricos. La internación fue indicada principalmente desde las Salas de Urgencias (67,3%). El 54,4% (98/180) estuvo hospitalizado de 1 a 3 días. En el 47,2% de los casos se indicó psicofarmacoterapia. Conclusión: Se registró mayor frecuencia de diagnóstico psiquiátrico en adolescentes y en el sexo femenino. La sospecha de abuso sexual infantil representó un frecuente motivo de ingreso. Las distintas formas de maltrato Infantil, los trastornos depresivos y los intentos suicidas, al constituir los diagnósticos psiquiátricos más frecuentes, requieren parámetros de evaluación y tratamiento específicos y efectivos para su adecuado manejo multidisciplinario. Las Salas de Urgencias Pediátricas cumplen un importante rol como puerta de entrada de estos pacientes al sistema de salud y al continuum de servicios de atención a la salud mental.

Introduction: New models of child and adolescent psychiatric hospitalizations are currently being implemented to meet the growing demand for intensive psychiatric care resources required by this population. Objective: To identify the clinical and demographic characteristics of children and adolescents with psychiatric diagnosis hospitalized on the Pediatric Service of a General Pediatric Hospital. Materials and Methods: This was a descriptive, retrospective cross-sectional study, based on the clinical histories of 180 hospitalized cases during January-August of 2015. Variables: Age, sex, place of origin, reason for admission, psychiatric diagnosis, type of psychiatric pathology, medication, clinical service from which the psychiatric evaluation was initiated, hospitalization days, follow-up and referral. Results: During the study period, 180 hospitalized patients were identified with one or more psychiatric diagnoses, of which 67.2% were female. The median age was 13 years. Of a total of 387 diagnoses found, the six most frequent psychiatric diagnoses were: different types of child abuse (42.89%), depressive disorders (21.71%), suicide attempts (8.27%), adaptive disorders (4.39%) and post traumatic stress disorder (4.13%). 56% had two or more comorbid psychiatric diagnoses. The hospitalization was initiated mainly from the Emergency Department (67.3%). 54.4% (98/180) were hospitalized for 1 to 3 days. In 47.2% of cases, psychopharmacotherapy was indicated. Conclusion: There was a higher frequency of psychiatric diagnoses in adolescents and in the female sex. Suspicion of child sexual abuse represented a frequent reason for admission. The different forms of child abuse, depressive disorders and suicide attempts, as they constitute the most frequent psychiatric diagnoses, require specific and effective evaluation and treatment parameters for their adequate multidisciplinary management. The Pediatric Emergency Department plays an important role as a gateway for these patients into the health system and the mental health care services continuum.

A psychotic experience during adolescence: reasoning about differential diagnosis. case report

ABSTRACT CONTEXT: The aim of the present clinical review was to illustrate the diagnostic difficulty associated with psychotic experiences during adolescence, in the light of the multiplicity of circumstances interplaying during this period. It was also intended to illustrate the observation that not all hallucinations occur in the context of a declared psychotic disorder. Case Report: The patient was a 16-year-old adolescent girl who came to the Emergency Department of Coimbra Pediatric Hospital. On admission, she displayed mood and sensory perception disorders, with a bizarre gait abnormality. A diagnosis of conversion disorder was finally suggested, in accordance with the International Classification of Diseases, 10th edition. CONCLUSIONS: Conversive hallucinations are rare in the psychiatric literature. This diagnostic hypothesis only gained consistency over a long period of follow-up within a child and adolescent psychiatry outpatient service, which was fundamental for appropriate diagnostic clarification. The authors discuss psychotic experiences that can arise from a neurotic setting and share the reasoning that was constructed in relation to the differential diagnosis. The psychogenesis and phenomenology of this young patient's conversive hallucinations and the therapeutic strategies adopted over the course of the follow-up are also discussed.

Educación Médica Continua SOPNIA. Experiencia de Implementación de Cursos E-Learning en Neurología Pediátrica / Continuing medical education SOPNIA. Experience of implementing e-learning courses in Pediatric Neur

Resumen: El programa de Educación Médica Continua (EMC) de SOPNIA consiste en actividades científicas orientadas a la actualización permanente en Neurología y Psiquiatría de niños y adolescentes. Está dirigido a socios SOPNIA, médicos especialistas en Neurología Pediátrica, Psiquiatría de la Infancia y Adolescencia y médicos especialistas certificados de especialidades afines (1).Este programa desde el año 2014 inicia cursos de capacitación de post grado vía e-learning, ya que este sistema permite flexibilidad de tiempo, mayores oportunidades para acceso, favorece el desarrollo de competencias y destrezas específicas como el estudio autorregulado, con una modalidad 100% on-line a través de nuestra plataforma vía página web de SOPNIA. Se analiza experiencia realizada Palabras clave: educación médica continua, Psiquiatría infantil, Neurología pediátrica, curso e-learning, educación en página web.

The continued medical education program (EMC) of SOPNIA consists of scientific activities aimed at updating physicians on pediatric neurology and psychiatry. It is aimed at SOPNIA members, specialists in pediatric neurology, child and adolescent psychiatry and certified physicians of related medial specialties.Since 2014, this program began graduate training via e-learning, for this system allows time flexibility, greater access opportunity, favors the development of specific skills and competencies such as self-regulated study, with a 100% online mode through our platform via SOPNIA website. We analyze our experience.Key words: continued medical education, child and adolescent psychiatry, pediatric neurology, e-learning, online education, website education

Validation of the Center for Epidemiological Studies Depression Scale among Korean Adolescents

OBJECTIVE: The Center for Epidemiological Studies Depression Scale (CES-D) is designed to measure the current level of depressive symptomatology in the general population. However, no review has examined whether the scale is reliable and valid among children and adolescents in Korea. The purpose of this study was to test whether the Korean form of the CES-D is valid in adolescents. METHODS: Data were obtained from 1,884 adolescents attending grades 1–3 in Korean middle schools. Reliability was evaluated by internal consistency (Cronbach’s alpha). Concurrent validity was evaluated by a correlation analysis between the CES-D and other scales. Construct validity was evaluated by exploratory factor and confirmatory factor analyses. RESULTS: The internal consistency coefficient for the entire group was 0.88. The CES-D was positively correlated with scales that measure negative psychological constructs, such as the State Anxiety Inventory for Children, the Korean Social Anxiety Scale for Children and Adolescents, and the Reynold Suicidal Ideation Questionnaire, but it was negatively correlated with scales that measure positive psychological constructs, such as the Korean version of the Rosenberg Self-Esteem Scale and the Connor-Davidson Resilience Scale-2. The CES-D was examined by three-dimensional exploratory factor analysis, and the three-factor structure of the scale explained 53.165% of the total variance. The variance explained by factor I was 24.836%, that explained by factor II was 15.988%, and that explained by factor III was 12.341%. The construct validity of the CES-D was tested by confirmatory factor analysis, and we applied the entire group’s data using a three-factor hierarchical model. The fit index showed a level similar to those of other countries’ adolescent samples. CONCLUSION: The CES-D has high internal consistency and addresses psychological constructs similar to those addressed by other scales. The CES-D showed a three-factor structure in an exploratory factor analysis. The present findings suggest that the CES-D is a useful and reliable tool for measuring depression in Korean adolescents.

Reliability and Validity of a New Comprehensive Tool for Assessing Challenging Behaviors in Autism Spectrum Disorder

OBJECTIVE: The purpose of this study was to examine the validity and reliability of the Korean Comprehensive Scale for the Assessment of Challenging Behavior in Developmental Disorders (K-CSCB). METHODS: In total, the parents of 189 patients with autism spectrum disorder (ASD) and 168 controls completed the K-CSCB, the Behavior Problems Inventory (BPI) and Child Behavior Checklist (CBCL). The reliability and validity of the K-CSCB was investigated. RESULTS: The K-CSCB was found to be a reliable instrument (Cronbach's α=0.97). There was a significant difference between the ASD and control groups in all subscale scores. Scores on the K-CSCB subscales were significantly correlated with those on the BPI and CBCL. The diagnostic validity was 97.7%, and the cut-off score with the highest sensitivity and specificity was 12.5 points. CONCLUSION: The K-CSCB is the first tool in Korean to assess problematic behavior in individuals with ASD, and this study shows that it is a valid and reliable instrument. We expect the K-CSCB to be widely used in clinical and research settings.

Sintomatología depresiva en una población universitaria de Colombia: Prevalencia, factores relacionados y validación de dos instrumentos para tamizaje / Depressive symptoms in a university population in Colombia: prevalence, related factors, and validation of two scores for screening

Resumen Introducción: La depresión en adolescentes es un problema silente de salud mundial, la cual, en ausencia de tratamiento, tiene efectos deletéreos en la salud física, bienestar psicosocial y rendimiento académico. Se requiere la validación de un instrumento que pueda emplearse como tamizaje en población adolescente, que permita conocer la prevalencia síntomas depresivos en una población universitaria. Objetivo: Calcular la prevalencia, de síntomas depresivos, factores asociados y validar dos instrumentos que puedan emplearse como método de tamizaje en poblaciones universitarias. Método: Estudio de corte transversal en adolescentes mayores de 18 años matriculados durante el primer semestre de 2016 en la Universidad Tecnológica de Pereira. La información recopilada incluye variables sociodemográficas y los resultados de la escala del Centro de Estudios Epidemiológicos para Depresión (CES-D) y el test de depresión de ZUNG. Resultados: Se obtuvo una muestra de 350 adolescentes, de los cuales se identificaron síntomas depresivos en la última semana de 8,85% y 36,28% para la escala de ZUNG y el CES-D respectivamente. La presencia de sintomatología depresiva se vio asociada con inactividad física (odds ratio [OR] = 2,1; intervalo de confianza de 95% [IC 95%], 1,1-5,8), consumo de alcohol (OR = 3,1; IC 95%, 1,8-5,3) y de sustancias psicoactivas (OR = 3,6; IC 95%, 1,9-6,6). Conclusiones: Se realiza por primera vez en el Eje Cafetero Colombiano una validación de la escala de ZUNG y CES-D, las cuales pueden ser utilizadas en población universitaria para tamizaje de sintomatología depresiva, siendo ambas equiefectivas con alpha de Cronbach de 0,84 y 0,87 respectivamente.

Background: Adolescent depression is a silent global health problem, untreated depression has detrimental effects on physical health, psychosocial well-being, and academicproductivity. Validation of an instrument that can be used as screening in adolescents and which would allow determination of its prevalence is required. Objectives: Estimate the prevalence of depressive symptoms, associated factors and validate two instruments that can be used as a screening tool in university students. Methodology: Cross-sectional study in adolescents 18 years and older enrolled in first half of 2016 at the Universidad Tecnológica de Pereira. Information collected included sociodemographic variables and the results of scale epidemiological studies center for depression (CES-D) and the Zung depression test. Results: A sample of350 adolescents, of whom depressive symptoms were identified in the last week of 8.85% and 36.28% for the Zung scale and CES-D was obtained respectively. The presence of depressive symptoms was associated with physical inactivity (odds ratio [OR] = 2.1; confidence interval 95% [95% CI], 1.1 to 5.8), alcohol consumption (OR = 3,1; 95% CI, 1.8 to 5.3) andpsychoactivesubstances (OR = 3.6,95% CI 1.9 to 6.6). Conclusions: For the first time in Coffe region area is realized the validation of the Zung and CES-D depression test, which can be used in university population screening for depressive symptoms, both of them are equieffective with Cronbach's alpha of 0.84 and 0.87 respectively.

Low Muscle Mass and Depressed Mood in Korean Adolescents: a Cross-Sectional Analysis of the Fourth and Fifth Korea National Health and Nutrition Examination Surveys

BACKGROUND: Muscle mass and muscle function are related to depressed mood in studies of adults. Like adults, Korean students are highly likely to suffer from decreased muscle mass due to social conditions. In this study, we evaluated the muscle mass status of Korean adolescents and assess the effect of muscle on depressive mood. METHODS: A total of 1,233 adolescent boys and girls participants from the Korea National Health and Nutrition Examination Survey were enrolled in our study. Participants underwent dual-energy X-ray absorptiometry for assessment of appendicular muscle mass and completed questionnaires regarding depressed mood, stress, suicidal ideations, and attempts. RESULTS: There was no difference in depressive mood according to muscle mass among boys (P = 0.634); girls with decreased muscle mass had a greater tendency for depressed mood compared to girls with optimal muscle mass (P = 0.023). After adjusting for age, waist circumference-to-height ratio, smoking status, alcohol consumption, frequency of physical activity, self-reported obesity, weight-loss efforts, and monthly household income, girls with low muscle mass (LMM) were 2.60 times more at risk of developing depression than girls with normal muscle mass (95% confidence interval [CI], 1.05–6.49; P = 0.040). This trend was similar for girls with LMM with obesity (95% CI, 1.00–11.97; P = 0.049). CONCLUSION: Adolescent girls who have insufficient muscle mass are more likely to report depressed mood than girls who have ideal muscle mass. Interventions for maintaining proper muscle mass are required.

Current Challenges and Future Opportunities for Child and Adolescent Psychiatry in Japan

Japan has been facing a serious shortfall of child and adolescent psychiatric workforce relative to increasing service needs. Likely because of a combination of limited workforce supply and limited trust or perception of effectiveness, mental health services are under-utilized by the educational and child welfare systems. Child and adolescent psychiatry (CAP) has not been a formally established specialty in Japan. The lack of basic structure in the specialty most likely contributes to a lack of training facilities, limited exposure to and interest in the specialty, and hence an inadequate workforce. To date, there exists no standardized training program for CAP in Japan and each training hospital determines its own teaching curriculum and training content. Clinical experience in CAP varies greatly among hospitals. To solve current problems in child and adolescent psychiatry in Japan, we advocate for the development and establishment of a more standardized child and adolescent psychiatry training system that is akin to what exists in the US and that teaches and evaluates according to specific competencies. Through standardizing care and education and ultimately improving workforce, the quality of mental health services can be raised. The tragic and costly consequences of unidentified and untreated mental illness in youth can be avoided by taking timely evidence based actions in partnership with others.

Current Challenges and Future Opportunities for Child and Adolescent Psychiatry in Japan

Japan has been facing a serious shortfall of child and adolescent psychiatric workforce relative to increasing service needs. Likely because of a combination of limited workforce supply and limited trust or perception of effectiveness, mental health services are under-utilized by the educational and child welfare systems. Child and adolescent psychiatry (CAP) has not been a formally established specialty in Japan. The lack of basic structure in the specialty most likely contributes to a lack of training facilities, limited exposure to and interest in the specialty, and hence an inadequate workforce. To date, there exists no standardized training program for CAP in Japan and each training hospital determines its own teaching curriculum and training content. Clinical experience in CAP varies greatly among hospitals. To solve current problems in child and adolescent psychiatry in Japan, we advocate for the development and establishment of a more standardized child and adolescent psychiatry training system that is akin to what exists in the US and that teaches and evaluates according to specific competencies. Through standardizing care and education and ultimately improving workforce, the quality of mental health services can be raised. The tragic and costly consequences of unidentified and untreated mental illness in youth can be avoided by taking timely evidence based actions in partnership with others.

Utilization of Western and Traditional Korean Medicine for Children and Adolescents with Mental Disorders: a Nationwide Population-based Study from 2010 to 2012

When in need of medical treatment, Korean citizens have a choice of practitioners of western medicine (WM) or Traditional Korean Medicine (TKM). However, the two branches frequently conflict with one another, particularly with regard to mental disorders. This study was designed to compare the utilization of WM and TKM, focusing on child/adolescent patients with mental disorders. We analyzed F-code (Mental and behavioral disorders) claims from the Korean Health Insurance Review and Assessment Service, including data from 0-18-year-old patients from 2010 to 2012. Slightly more men than women utilized WM, while TKM use was almost evenly balanced. WM claims increased with advancing age, whereas utilization of TKM was common for the 0-6 age group. In WM and TKM, the total number of claims relying on the National Health Insurance Service (NHIS) was 331,154 (92.78%) and 73,282 (97.85%), respectively, and the number of claims relying on medical aid was 25,753 (7.22%) and 1,610 (2.15%), respectively. The most frequent F-coded claim in WM was F90 (Hyperkinetic disorders), with 64,088 claims (17.96%), and that in TKM was F45 (Somatoform disorders), with 28,852 claims (38.52%). The prevalence of a single disorder without comorbidities was 168,764 (47.29%) in WM and 52,615 (70.25%) in TKM. From these data, we conclude that WM takes prevalence over TKM in cases of attention deficit/hyperactivity disorder (ADHD), as well as in psychological problems such as depression and anxiety. On the other hand, patients utilizing TKM more commonly present with physical health problems including somatoform problems, sleep, and eating disorders.

Evaluation of anxiety and depression prevalence in patients with primary severe hyperhidrosis

BACKGROUND: Primary hyperhidrosis (PH) can lead to mood changes due to the inconveniences it causes. OBJECTIVE: This study aimed to examine the existence of anxiety and depression in patients with severe primary hyperhidrosis who sought treatment at a medical office. METHODS: The questionnaire "Hospital Anxiety and Depression Scale" was used for 197 individuals, in addition to the chi square test and Fisher exact test, p <0.05. RESULTS: There was an increased prevalence of anxiety (49.6%) but not of depression (11.2%) among patients with PH, with no link to gender, age or amount of affected areas. Palmar and plantar primary hyperhidrosis were the most frequent but when associated with the presence of anxiety, the most frequent were the axillary (p = 0.02) and craniofacial (p = 0.02) forms. There was an association between patients with depression and anxiety (p = 0.001). CONCLUSIONS: the involvement of Primary hyperhidrosis was responsible for a higher prevalence of anxiety than that described among the general population and patients with other chronic diseases. Depression had a low prevalence rate, while mild and moderate forms were the most common and frequently associated with anxiety. The degree of anxiety was higher in mild and moderate types than in the severe form. .

Factores de riesgo relacionados con la conducta suicida en la infancia y adolescencia / Risk factors related to suicidal behavior in childhood and adolescence

Se realizó un estudio observacional, descriptivo y transversal en el Hospital Infantil Norte Docente "Dr. Juan de la Cruz Martínez Maceira" de la provincia de Santiago de Cuba en el 2010, a fin de describir los factores relacionados con la conducta suicida en 26 de 31 adolescentes de 11 a 17 años, atendidos en dicha institución durante ese período. Se halló que el grupo más afectado fue el de 14-15 años, con primacía del sexo femenino. Entre los factores de riesgo predominantes figuraron, por citar los principales en la casuística: los maltratos físicos y psicológicos como las humillaciones efectuadas por los propios padres; la falta de redes de apoyo familiar en la mayoría de ellos; la ausencia de solución de sus problemas; la ingestión de medicamentos para suicidarse, fundamentalmente psicofármacos, así como la depresión y el consumo de alcohol como antecedentes patológicos familiares.

An observational, descriptive and cross sectional study was carried out in "Dr. Juan de la Cruz Martínez Maceira" Teaching Northern Pediatric Hospital from Santiago de Cuba province in 2010, in order to describe the factors related to the suicidal behavior in 26 of 31 adolescents from 11 to 17 years, assisted in this institution during that period. It was found that the most affected group was that of 14-15 years, with prevalence of the female sex. Among the predominant risk factors there were, as the main ones in the case material: the physical and psychological abuses as the humiliations carried out by parents; the lack of family support groups in most of them; the absence of solution to their problems; the drugs ingestion to commit suicide, fundamentally psychodrugs, as well as depression and the alcohol consumption as family pathological history.