Strengths and Difficulties Questionnaire (SDQ): An update of the literature and instrumental study with schoolchildren

Introduction: Considering the current controversy regarding the factorial structure of the SDQ, this paper aimed to analyse the dimensionality and reliability of the parents' version for children from 4 to 16 years of age, and to present descriptive data according to sociodemographic variables. Method: The factor structure of the original five- and three-factor models, and the reliability of the SDQ were examined among a sample of 621 parents of Uruguayan children between 7 and 12 years of age (52% girls) from different socioeconomic levels. Results: Confirmatory factor analyses did not provide support for the five- and three-factor models. Data adjusted to three factors (prosociality, externalising symptoms, internalising symptoms) in an exploratory analysis with adequate reliability indices. Conclusions: The results of this study show the relevance of continued investigation of the SDQ internal structure, and further analysis of the behaviour of several of its items.

Introducción: Considerando la controversia vigente respecto a la estructura factorial del SDQ, este trabajo tuvo como objetivo analizar la validez de constructo y fiabilidad de la versión para padres de niños de 4 a 16 años y presentar datos descriptivos según variables sociodemográficas. Método: Se examinó la estructura factorial de los modelos originales de cinco y tres factores y la fiabilidad del SDQ en una muestra de 621 padres de niños uruguayos entre 7 y 12 años (52 % niñas) de distintos niveles socioeconómicos. Resultados: Los análisis factoriales confirmatorios no pudieron dar apoyo a los modelos de cinco y tres factores. Los datos se ajustaron a tres factores (prosocialidad, síntomas externalizantes y síntomas internalizantes) en un análisis exploratorio con adecuados índices de fiabilidad. Conclusiones: Los resultados de este estudio muestran la pertinencia de continuar investigando la estructura interna del SDQ y analizar con mayor profundidad el comportamiento de algunos de sus ítems.

Abuso sexual en niños, niñas y adolescentes: factores de riesgo y sintomatología

Objetivo: Analizar avances en la literatura científica sobre factores de riesgo y sintomatología a corto y largo plazo del abuso sexual en niños, niñas y adolescentes. Método: Mediante una revisión de artículos científicos en inglés y en español, se seleccionaron 27 investigaciones disponibles en APA PsycArticles, Dialnet, Springer y ScienceDirect, entre 2011 y 2020 con información cuantitativa o cualitativa sobre factores de riesgo y sintomatología del abuso sexual en niños, niñas y adolescentes. Resultados: Se identifican factores de riesgo asociados a grupos etarios, principalmente entre 6-7 y 12-13 años, tipos de familias reconstituidas, así como a la presencia de cuidadores distintos a los padres. Entre los síntomas a corto plazo, se identifican cambios bruscos de comportamiento, dificultades en las relaciones interpersonales, angustia, miedo y culpa. Además, se registran lesiones físicas y alteraciones somáticas. A largo plazo se identifican síntomas asociados a estrés postraumático, conductas suicidas, trastornos alimenticios, dificultades de interacción social y en menor medida drogodependencia. Conclusiones: Respecto a los factores de riesgo se visibiliza el uso de redes sociales como un referente a considerar en las dinámicas actuales. Sin embargo, la literatura enfatiza en seguir consolidando el análisis de estos factores y su articulación con acciones pertinentes para la prevención y atención oportuna del abuso. En cuanto a la sintomatología se evidencian avances en el análisis a corto plazo, pues no sólo se aborda lo físico y fisiológico sino también desde lo psicosocial. Similarmente, el análisis de la sintomatología a largo plazo se orienta principalmente a procesos psicosociales.

Objective: To analyze current scientist literature advances about risk factors and symptomatology of sexual abuse in children and adolescents. Method: A literature review was conducted by consulting english and spanish documents available in APA PsycArticles, Dialnet, Springer and Science Direct databases. 27 research papers published between 2011 and 2020 was selected. They provide quantitative or qualitative information about risk factors and symptomatology of sexual abuse in children and adolescents. Results: Main findings describe risk factors associated with age groups, mainly between 6-7 and 12-13 years, types of reconstituted families, as well as the presence of caregivers different to parents. Short-term symptoms include abrupt changes in behavior, difficulties in interpersonal relationships, anguish, fear and guilt. In addition, physical injuries and somatic alterations are identified. In the long term, symptoms are associated with post-traumatic stress, suicidal behaviors, eating disorders, difficulties in social interaction and sometimes with drugs abuse. Discussions: Regarding risk factors, the use of social media is visible as a reference to be considered in current dynamics. However, the literature emphasizes the need to continue consolidating the analysis of these factors and their articulation with pertinent actions for the prevention and timely attention of abuse. Regarding symptomatology, there is evidence of progress in the short-term analysis, since not only the physical and physiological aspects are addressed, but also the psychosocial aspects. Similarly, the analysis of long-term symptomatology is mainly oriented to psychosocial processes.

Caracterización clínica y sociodemográfica de Diabetes Mellitus en pacientes pediátricos del Hospital Regional de la Orinoquía, Yopal, Colombia

Introducción: La Diabetes Mellitus (DM) es una alteración metabólica crónica, creciente en la población pediátrica que conduce a múltiples complicaciones micro y macrovasculares. Es un problema de salud pública por los altos costos que conlleva el diagnóstico y tratamiento. Según la Federación Internacional de Diabetes (IFD), la incidencia anual en el mundo está aumentando, debido a que la prevalencia de edad entre 0-14 años es de 98.2% y de 0-19 años es de 128.9% entre el 2019 y 2021 con una incidencia de 108.3% y 149.5%, respectivamente, por 100.000 habitantes en 215 países. Objetivo: Describir las características clínicas de un grupo de niños y adolescentes que ingresaron al servicio de urgencias del Hospital Regional de la Orinoquía (HORO) de Yopal-Casanare, en el período 2019 -2020 con diagnóstico de novo o previo de diabetes mellitus. Metodología: Se realizó un estudio observacional, descriptivo y retrospectivo, tipo serie de casos, donde se incluyeron pacientes menores de 18 años con diagnóstico de novo o previo de diabetes mellitus en el período de 2019 -2020 en el Hospital Regional de la Orinoquía. Se analizaron un total de 15 pacientes. Resultados: Se muestra la clasificación de los pacientes según grupo de edades y sexo, se encuentra predominio del género masculino con un 53,3% de los 15 pacientes que cumplían con los criterios diagnósticos, mientras que la población femenina fue de 46,6%. La edad promedio de los pacientes pediátricos fue de 13 ± 13.2 Conclusiones: En el estudio realizado en el Hospital regional de la Orinoquía, la edad entre 11 - 13 años es la más frecuente para DM, con un predominio significativo del sexo masculino, provenientes de áreas urbanas. Se halló que el bajo peso es un dato alarmante, además de valores de glicemia alterados que se relacionan con las complicaciones presentadas al momento del ingreso del paciente, lo cual representa un problema de salud pública entre niños y adultos jóvenes debido a la heterogeneidad, del factor genético y ambiental.

Introduction: Diabetes mellitus (DM) is a chronic metabolic disorder that is increasing in the pediatric population and leads to multiple microvascular and macrovascular complications. It is a public health problem due to the high costs of diagnosis and treatment. According to the International Diabetes Federation (IFD) the annual incidence in the world is increasing, due to an age prevalence between 0-14 years of 98.2% and 0-19 years of 128.9% between 2019 and 2021 with an incidence of 108.3% and 149.5% respectively per 100,000 inhabitants in 215 countries. Objective: To describe the clinical characteristics of a group of children and adolescents admitted to the emergency department of the Hospital Regional de la Orinoquía (HORO) in Yopal-Casanare in the period 2019 to 2020 with de novo or previous diagnosis of diabetes mellitus. Methodology: An observational, descriptive, and retrospective study, case series type, where patients under 18 years of age with de novo or previous diagnosis of diabetes mellitus were included in the period from 2019 to 2020 in the Orinoquía Regional Hospital. Results: The classification of the patients according to age group and sex shows a predominance of the male gender with 53.3% of the 15 patients who met the diagnostic criteria, while the female population was 46.6%. The average age of the pediatric patients was 13 ± 13.2 Conclusions: The study carried out at the Hospital Regional de la Orinoquía showed that the most frequent age group was 11 to 13 years old, with a significant predominance of males, coming from urban areas. It was found that low weight is an alarming fact plus altered glycemia values are related to the complications presented at the time of the patient's admission, which represents a public health problem among children and young adults due to the heterogeneity of the genetic and environmental factors.

Metacognición, insight clínico y sintomatología en pacientes ambulatorios chilenos con Esquizofrenia

Introducción: Las personas con esquizofrenia presentan graves dificultades para formar ideas complejas sobre sí mismos y otros, definidas como déficits metacognitivos, junto a menor insight clínico o capacidad para tomar conciencia de poseer un trastorno de salud mental. El presente estudio evaluó dichas alteraciones y las correlaciones entre metacognición, insight clínico y sintomatología en pacientes ambulatorios con esquizofrenia. Metodología: Se diseñó un estudio cuantitativo, relacional, prospectivo, transversal y observacional. Treinta y un pacientes ambulatorios del Centro Diurno "Luz y Esperanza" de Talca (Chile) fueron evaluados utilizando la Metacognitive Assessment Scale-Abbreviated, Scale of Unawareness of Mental Disorder y la Escala de Síndromes Positivo y Negativo, en el período 2019-2020. Resultados: Se encontraron bajos puntajes metacognitivos y de insight clínico, destacando las correlaciones estadísticamente significativas de puntaje metacognitivo total, Autorreflexividad y Maestría con escasa Conciencia de poseer un trastorno y las subescalas de síntomas negativos y desorganización. Conclusiones: Nuestros resultados respaldan la inclusión de los déficits metacognitivos y de insight clínico en los modelos de esquizofrenia. Se discute sobre su potencial aporte en el diseño de intervenciones psicoterapéuticas que promuevan estas capacidades e influyan en los síntomas negativos y de desorganización. Es necesario replicar estudios sobre estas variables en nuestro país, que incluyan un mayor número de participantes.

Introduction: People with schizophrenia have serious disturbances in forming complex ideas about themselves and others, defined as metacognitive deficits, along with less clinical insight or awareness of mental disorder The present study assessed these disturbances and the correlations between metacognition, clinical insight and symptomatology in outpatients with schizophrenia. Methods: A quantitative, relational, prospective, cross-sectional and observational study was designed. Thirty-one outpatients of the "Luz y Esperanza" Day Center in Talca (Chile) were evaluated using the Metacognitive Assessment Scale-Abbreviated, Scale of Unawareness of Mental Disorder and the Positive and Negative Syndrome Scale, in the period 2019-2020. Results: Low metacognitive and clinical insight scores were found, highlighting statistically significant correlations of total metacognitive score, Self-Reflectivity and Mastery with low Awareness of mental disorder and the subscales of negative symptoms and disorganization. Conclusions: Our results support the inclusion of metacognitive deficits and clinical insight in schizophrenia models. Its potential contribution to the design of psychotherapeutic interventions that promote these abilities and influence negative and disorganized symptoms is discussed. It is necessary to replicate studies about these variables in our country, including a greater number of participants.

Terapia sistémica breve en personas expuestas a un evento altamente estresante reciente: Un ensayo controlado aleatorizado / Brief systemic therapy in people exposed to a recent highly stressful event: A randomised controlled trial

Resumen: Antecedentes: Los eventos altamente estresantes pueden tener efectos nocivos en el bienestar y salud mental en las personas. Objetivo: Evaluar la eficacia de un protocolo de intervención preventiva basado en la Terapia Sistémica Breve orientado a personas que vivenciaron de manera reciente un evento altamente estresante. Método: Participaron 75 personas, 39 conformaron el grupo experimental y 36 el grupo control. Para el análisis de los datos se siguió un diseño cuantitativo con dos grupos (experimental y control) y con dos puntos temporales (pre y post-intervención). Al grupo experimental se añadió un seguimiento a los seis meses. El protocolo estuvo estructurado en cuatro sesiones y apuntaba a incidir sobre los síntomas postraumáticos, el crecimiento postraumático, la respuesta rumiativa y las estrategias de afrontamiento. Resultados: Se observó un aumento del crecimiento postraumático, de la rumiación deliberada, del afrontamiento centrado en el problema y de la reinterpretación positiva en el grupo experimental. En cambio, solo hubo una tendencia no significativa en la reducción de la sintomatología postraumática y en la búsqueda de apoyo social. Conclusiones: Estos resultados contribuyen al desarrollo de la Terapia Sistémica Breve y apoyan su utilidad en la intervención preventiva con personas expuestas a un evento altamente estresante.

Abstract: Background: Highly stressful events can have harmful effects on people's well-being and mental health. Objective: To evaluate the efficacy of a preventive intervention protocol based on Brief Systemic Therapy oriented to people who recently experienced a highly stressful event. Method: Seventy-five people participated, 39 were in the experimental group and 36 in the control group. A quantitative design with two groups (experimental and control) and two time points (pre- and post-intervention) was used for data analysis. A six-month follow-up was added to the experimental group. The protocol was structured in four sessions and aimed to impact on posttraumatic symptoms, posttraumatic growth, ruminative response and coping strategies. Results: An increase in posttraumatic growth, deliberate rumination, problem-focused coping, and positive reinterpretation was observed in the experimental group. In contrast, there was only a nonsignificant trend in reduced posttraumatic symptomatology and in seeking social support. Conclusions: These results contribute to the development of Brief Systemic Therapy and support its usefulness in preventive intervention with people exposed to a highly stressful event.

A Review on Pararasasekaram Symptomatology about Karpavippuruthi with Modern Symptomatology

The Siddha System of medicine, which had its presence in the historic Tamil lands one the most of all different clinical structures in the world. Around 4448 illnesses are described through Siddhars of their books and literatures, which might be subdivided into Vatha noi, Pitha noi, Kabha noi, Kasanoi, Soolai, Karapan, Kiraani, Vippuruthi etc. In Vippuruthi noikal Karpavippuruthi is one of the regularly encountered gynaecological illnesses, which turned into cited within the posted literature Pararasasekaram Irandavathu Karparoga Nithanam. The signs and symptoms of Karpavippuruthi cited in the Siddha literature can be correlated with uterine cancer and uterine fibroid in the modern disease of classificatory. The comparative research of Siddha system of medication convey to mild excessive stage of clinical expertise the Siddhars had. The research was focused at evolve a set of absolute Siddha diagnostic strategies for Karpavippuruthi and to correlate the signs and symptoms of Karpavippuruthi with that of carefully akin to situation in modern medical literature. By pertaining to the historic Siddha literature with current day, there could be each augmentation of the expertise of diagnosis and its remedy. This chapter was aimed in delving extensive into the clinical features cited under highly occurring disease “Karpavippuruthi” through Sage Pararasasekaram which in addition ends in shape the Siddha diagnosis and prognostic device of Karpavippuruthi.

Sintomatología y crecimiento postraumático en estudiantes de educación superior en Chile durante la pandemia por COVID-19

Objetivo. Evaluar un modelo predictivo de sintomatología postraumática (SPT) y de crecimiento postraumático (CPT), que incluía variables psicológicas, relacionadas con la pandemia y con las clases virtuales, en estudiantes de educación superior durante la pandemia. Método. Participaron 552 estudiantes cuya mayoría corresponde a un 68.5% de mujeres. Se aplicaron instrumentos para medir distintas variables psicológicas. Resultados. Se estableció que un modelo predictivo que incluía la rumiación intrusiva y deliberada, la severidad subjetiva, la supresión emocional, la revaluación cognitiva, el apoyo social, un espacio adecuado para conectarse a clases en línea y el nivel de estudios predecía en forma significativa la SPT. La rumiación deliberada, el apoyo social, la reevaluación cognitiva y la edad predecían el CPT. Se discute la relevancia de estos resultados para el apoyo que se podría brindar a los estudiantes.

Objective. To evaluate a predictive model of posttraumatic symptomatology (PTS) and posttraumatic growth (PTC), which included psychological, pandemic-related, and online classroom-related variables, in higher education students during the pandemic. Method. A total of 552 students participated, 68.5% of whom were women. Instruments were applied to measure different psychological variables. Results. It was established that a model that included intrusive and deliberate rumination, subjective severity, emotional suppression, cognitive reappraisal, social support, adequate space to connect to online classes, and educational attainment significantly predicted PTS. Deliberate rumination, social support, cognitive reappraisal, and age predicted CPT. The relevance of these findings to the academic support that could be provided to students is discussed.

Psicoterapia para la regulación emocional desde un enfoque transdiagnóstico: revisión de ensayos clínicos aleatorizados / Psychotherapy for emotional regulation from transdiagnostic approach: a review of randomized clinical trials

Resumen Introducción: La regulación emocional (RE) refiere a los procesos por los cuales los individuos influyen en las emociones que tienen, cuando las tienen y cómo las experimentan y expresan (Gross, 1998). El uso de estrategias desadaptativas de RE se asocia con distintos cuadros psicopatológicos. La concepción de RE como proceso transdiagnóstico permite sortear el problema de la comorbilidad, y ha sido abordado desde distintos modelos e investigaciones. Objetivo: El presente estudio se propone realizar una revisión de ensayos clínicos aleatorizados de psico-terapia para la RE desde una perspectiva transdiagnóstica. Método: Para ello se realizó una búsqueda en las bases de datos PubMed, SciELO, Redalyc y ScienceDirect. Resultados: Se hallaron 11 artículos que cumplían los criterios de inclusión. Los resultados mostraron que las intervenciones transdiagnósticas obtuvieron mejores resultados que grupos control, que incluyeron otros tratamientos o listas de espera. Conclusión: Se señala la importancia de realizar más ensayos clínicos aleatorizados que comparen nuevas intervenciones con tratamientos de primera línea.

Abstract Introduction: Emotional regulation (ER) refers to the processes by which individuals influence the emotions they have, when they have them and how they experience and express them (Gross, 1998). The use of maladaptive ER strategies is associated with different psychopathological conditions. The conception of ER as a transdiagnostic process allows to overcome the problem of comorbidity, and has been approached from different models and investigations. Objective: The present study aims to conduct a review of randomized clinical trials of psychotherapy for ER from a transdiagnostic perspective. Method: For this, a search was carried out in the databases PubMed, SciELO, Redalyc and ScienceDirect. Results: Eleven articles were found that met the inclusion criteria. The results showed that the transdiagnostic interventions obtained better results than control groups, which included other treatments or waiting lists. Conclusion: The importance of conducting more randomized clinical trials comparing new interventions with first-line treatments is noted.

Clinical Spectrum of Tuberculosis

Being the second leading cause of mortality due to infectious diseases, the burden of tuberculosis is huge globally as well as in India. Therefore, timely diagnosis and treatment are essential to improve the clinical outcomes of the disease. It is therefore essential to create awareness and educate all concerned regarding the clinical spectrum of the disease which includes both pulmonary and extrapulmonary manifestations. Apart from typical systemic manifestations, depending on the organ affected infected patients may present with atypical signs and symptoms. The challenge is establishing definitive diagnosis in absence of discrete symptoms. Also, the EPTB generally are insidious in onset and diagnosis usually occurs in advanced stages. Therefore, a high index of suspicion is necessary particularly in absence of fever, weight loss and fatigue to avoid delay in diagnosis and thereby reduce risk of complications. It is worth mentioning that apart from high-risk individuals with HIV, chronic kidney failure, poor glycemic control, patients being treated with immunosuppressants, and both pediatric and geriatric populations who are immunocompromised, TB can be reactivated and EPTB can occur regardless of the individuals’ immune status. This review article elucidates different clinical presentations of patients with both pulmonary and extra-pulmonary TB which may facilitate early management even in settings with lack of advanced diagnostic evaluation or additionally offer a right direction to perform appropriate investigations

Evaluación de un protocolo de intervención en Terapia Sistémica Breve para personas expuestas a un evento estresante reciente / Evaluation of a Brief Systemic Therapy intervention protocol for people who have experienced a recent stressful event

Resumen Los eventos altamente estresantes son sucesos que potencialmente generan consecuencias negativas en las personas afectadas, como síntomas postraumáticos y depresivos. El presente estudio evalúa un protocolo de intervención preventiva, orientado a personas que han vivido un evento altamente estresante reciente, basado en la Terapia Sistémica Breve. Cuatro terapeutas aplicaron el protocolo a cuatro usuarias. Se entrevistó a estas ocho personas acerca de su experiencia en la aplicación y recepción del protocolo. Mediante escalas de fiabilidad y validez contrastada se evaluaron los cambios pre-post en sintomatología postraumática, sintomatología depresiva, crecimiento postraumático y satisfacción con la vida; también se midió la relación terapéutica. Los resultados muestran apreciaciones positivas en terapeutas y usuarias, el desarrollo de una relación terapéutica adecuada y avances en tres de los cuatro indicadores cuantitativos de cambio. Se concluye que el protocolo está en condiciones de utilizarse en estudios controlados.

Abstract Highly stressful events are occurrences that potentially create negative consequences for the affected people, such as post-traumatic and depressive symptoms. This study assesses a preventive intervention protocol, aimed to people who have lived a recent highly stressful event, based on the Brief Systemic Therapy. Four therapists applied the protocol to four female users. These eight persons were interviewed about the experience in relation to the application and reception of the protocol. Through contrasted reliability and validity scales, pre and post changes in posttraumatic symptomatology, depressive symptomatology, posttraumatic growth and satisfaction with life were assessed; the therapeutic relation was also measured. The results show positive appraisals in therapists and female users, the development of a proper therapeutic relation and progress in three out of four quantitative change indicators. It is concluded that the protocol is suitable to be used in controlled studies.

Orientaciones filosóficas en la intervención fonoaudiológica de voz. El desafío actual de dar el alta / Philosophical orientations in voice therapy. The current challenge of discharge

El presente artículo corresponde a una reflexión sobre las orientaciones filosóficas en la terapia vocal actual. Cuando existe alguna alteración o trastorno vocal, se habla comunmente de un desequilibrio entre los subsistemas involucrados en el proceso fonatorio, es decir, fuelle (sistema respiratorio), fuente (pliegues vocales) y filtro (tracto vocal). Si no hay un correcto balance, entonces el sistema no tiene un correcto funcionamiento y pueden aparecer síntomas como ronquera, sensación de cuerpo extraño, prurito, fatiga vocal o bien disfonía o incluso afonía. Como con-secuencia de estas dificultades, se generan compensaciones que durante el proceso de la intervención fonoaudiológica el profesional debe volver a "equilibrar". Para lograr este objetivo, se desarrollan y analizan las diversas herramientas que entregan las filosofías de pensamiento a lo largo de la historia de la rehabilitación vocal, don-de se encuentran la orientación higiénica, psicológica, sintomatológica, fisiológica y ecléctica. En este mismo sentido, el profesional debe buscar lo que percibe como más idóneo para cada paciente o grupo a intervenir, centrado en mejorar la calidad vocal y las necesidades actuales de estos, basándose en el contexto mundial actual, con el objetivo de lograr un buen proceso de entrenamiento o rehabilitación y final-mente lograr el alta.

The present article corresponds to a reflection about the philosophical orientations in the current vocal therapy. When there are some vocal alterations or disorders, we usually talk about an imbalance between the sub-sysmtems involved in the fonatory process, which are bellows (respiratory system), source (vocal folds) and filter (vocal tract). When there is not a correct balance, the system does not work properly and as a consequence, it is possible to experiment symptoms such as hoarseness, foreign body sensation, pruritus, vocal fatigue, dysphonia or even aphonia. As a result of these difficulties, it is possible to generate compensations through the intervention of speech therapy. By virtue of this therapy the professional must 'balance'. In order to achieve this, it is necessary to develop and analyze the different tools that philoso-phical studies offer through the history of vocal rehabilitation. Some of these tools are hygienic orientation, psychological, symptomatological, physiological and eclec-tic. Thinking on that, the professional must search what it is most suitable for every patient or group of people that he/she will be working with. This must be focus on improving vocal quality and the actual necessities of the patient, based on the current global context. The final purpose of the professional is to achieve a good and healthy process of training and/or rehabilitation to accomplish medical discharge.

Metacognición, apego y sintomatología en esquizofrenia primer episodio / Metacognition, attachment and symptomatology in first-episode schizophrenia

Resumen: Los sujetos con Esquizofrenia experimentan menoscabo en la capacidad para formar ideas complejas sobre sí mismos y otros, definido como déficits metacognitivos. El presente estudio evaluó las correlaciones entre metacognición, apego y síntomas en pacientes con Esquizofrenia primer episodio en el Hospital Regional de Talca entre 2016 y 2018. Se diseñó un estudio cuantitativo, relacional, prospectivo, transversal y observacional. Treinta y un individuos fueron evaluados utilizando la Metacognitive Assessment Scale-Abbreviated para metacognición. También se evaluó apego y sintomatología. Se encontraron bajos puntajes metacognitivos y la mayoría de los participantes fueron catalogados como apego evitante. Menores capacidades metacognitivas se correlacionaron significativamente con mayor sintomatología negativa y de desorganización. Conclusiones. Nuestros resultados respaldan la inclusión de los déficits metacognitivos y patrones de apego en los modelos de Esquizofrenia, lo que podría mejorar nuestra comprensión de los síntomas negativos y de desorganización. Además, se discute sobre su aporte al desarrollo de intervenciones psicoterapéuticas en Esquizofrenia desde el primer episodio.

Abstract: Subjects with Schizophrenia experience decrements in their ability to form complex ideas about themselves and others, defined as metacognitive deficits. The current study assessed correlations between metacognition, attachment and symptoms in patients with first-episode Schizophrenia. A quantitative, relational, prospective, cross-sectional and observational study was designed. Thirty-one individuals were assessed using the Metacognitive Assessment Scale-Abbreviated for metacognition. Attachment and symptomatology were also measured. Results. Low metacognitive scores were found, and most participants were classified as dismissing attachment. Lower metacognitive abilities were significantly correlated with greater negative and disorganized symptoms. Conclusions. Our results support the inclusion of metacognitive deficits and attachment patterns in Schizophrenia models, which could improve our understanding of negative and disorganized symptoms. In addition, their contribution to the development of psychotherapeutic interventions in Schizophrenia from the first episode is discussed.

Espiritualidad, religiosidad y síntomas depresivos en personas mayores del norte de Chile / Spirituality, religiosity, and depressive symptoms among elderly Chilean people in the north of Chile

Resumen: La depresión no es un trastorno inevitable en la vejez, aunque su prevalencia sea significativamente alta y, especialmente, en las personas mayores chilenas. De cara a la promoción de la salud mental y al tratamiento de los síntomas depresivos se vuelve relevante ahondar en aquellos factores que puedan inhibir su incidencia. Al respecto, este estudio analiza la asociación entre la religiosidad, la espiritualidad y la depresión en personas mayores de 60 años. Se dispone de una muestra de 777 personas mayores de la región de Arica y Parinacota, 65% son mujeres, 43% tiene entre 60 y 69 años (media: 69.93 años, DT=7.12), 48 tiene pareja (casado o convive) y la mayoría vive en la ciudad de Arica (87%). Se realizaron análisis descriptivos, bivariados y un modelo de regresión jerárquica para depresión. Los resultados comprueban que solo las experiencias espirituales se relacionan con menor incidencia de síntomas depresivos. Concluyendo, los hallazgos muestran que en el tratamiento de la depresión geriátrica se podrían incluir recursos personales/psicológicos que movilizan el afrontamiento, la resiliencia y el optimismo, como es el caso de la espiritualidad.

Abstract: Depression is not an inevitable disorder in old age, although its prevalence is significantly high and especially among elderly Chilean people. In order to promote mental health and the treatment of depressive symptoms it becomes relevant to delve into those factors that can inhibit their incidence. In this regard, this study analyses the association between religiosity, spirituality and depression in people over 60 years. The sample was made up of 777 older Chilean adults living in the region of Arica and Parinacota, 65% are women, 43% are between 60 and 69 years old (mean: 69.93 years, SD = 7.12), 48 have a partner (married or living together) and the majority live in the city of Arica (87%). Descriptive and bivariate analyses of the study variables and a hierarchical regression analysis was conducted for the depression variable. The results prove that only spiritual experiences are related to lower incidence of depressive symptoms. Concluding, the findings show that in the treatment of geriatric depression could be included personal/psychological resources that mobilize coping, resilience and optimism, as is the case of spirituality.

Avaliação de Bem-Estar Psicológico e Sintomas Depressivos em Idosos Saudáveis / Evaluation of Psychological Well-Being and Depressive Symptoms in Healthy Elderly People / Evaluación de Bienestar Psicológico y Sintomas Depresivos en Los Idosos Saludables

O objetivo deste trabalho foi avaliar a relação entre bem-estar psicológico e a presença de sintomas depressivos em idosos saudáveis. Os instrumentos utilizados foram: ficha de dados sociodemográficos, EDEP e BDI-II. Os dados foram analisados com o auxílio do SPSS, por meio de frequências, média, desvio padrão e correlações de Spearman. A amostra foi composta por 64 idosos, com média de idade de 69,61 (DP=7,58) e média de escolaridade de 4,59 anos de estudo (DP=2,61). Os resultados indicaram correlação inversa, moderada e significativa entre sintomatologia depressiva e os domínios autonomia, ambiente e relações positivas com os outros, encontrou-se ainda correlação inversa e fraca entre sintomatologia depressiva e crescimento pessoal. Acredita-se que escolaridade e atividade física podem ser fatores protetivos para depressão e bem-estar psicológico no envelhecimento. Por fim, levanta-se a hipótese de haver uma retroalimentação entre as variáveis que se correlacionaram entre si de forma significativa neste estudo. (AU)

The main objective of this study was to evaluate the relationship between psychological well-being and depressive symptoms in healthy elderly people. The instruments used were: sociodemographic data questionnaire, EDEP and BDI-II. The data were analyzed in the SPSS using mean and SD, and Spearman correlations. The sample consisted of 64 elderly, with a mean age of 69.61 years (SD=7.58) and a mean educational level of 4.59 years (SD=2.61). The results indicate an inverse, moderate and significant correlation between depressive symptomatology and the domains: autonomy, environment, and positive relationships with others. There was also an inverse and weak correlation between depressive symptomatology and personal growth domain. It is believed that education level can be a protective factor for depression and psychological well-being in aging. Finally, the hypothesis is that there is a feedback cycle between the significantly correlated variables in this study. (AU)

El objetivo de este trabajo fue evaluar la relación entre bienestar psicológico y la presencia de síntomas depresivos en ancianos sanos. Los instrumentos utilizados fueron: ficha de datos sociodemográficos, EDEP y BDI-II. Los datos fueron analizados con la ayuda del SPSS, por medio de frecuencias, media, desviación estándar y correlaciones de Spearman. La muestra fue compuesta por 64 ancianos, siendo la media de edad fue 69,61 (+7,58) y la media de escolaridad fue de 4,59 años de estudio (+2,61). Los resultados indicaron correlación inversa, moderada y significativa entre sintomatología depresiva y los dominios autonomía, ambiente y relaciones positivas con los demás, se encontró una correlación inversa y débil entre sintomatología depresiva y crecimiento personal. Se cree que la escolaridad y la actividad física son factores protectores para la depresión y el bienestar psicológico en el envejecimiento. Por último, se plantea la hipótesis de que hay una retroalimentación entre las variables que se correlacionaron entre sí de forma significativa en este estudio. (AU)

Association of classical symptomatology with actual thyroid disease and the assessment of variations observed in thyroid profile: a comparative study between the elderly and the young adults

Background: The classical symptoms of thyroid dysfunction are valuable in being related to the value of TSH (thyroid stimulating hormone) and the occurrence of actual thyroid disease. There are significant variations seen in the clinical presentation of thyroid disorder in elderly patients, when compared to young adults, and the biochemical parameters of thyroid function also vary according to age and gender. Authors aimed to study the association of classical symptomatology of thyroid dysfunction with the presence of actual biochemically proven thyroid disorder, separately in two groups: one comprising elderly patients (?60 years)-Group A and other comprising young adult patients (25-50 years)-Group B.Methods: Patients attending the General Medicine out-patient department at Pushpagiri Medical College Hospital, Tiruvalla, Kerala, from December 2019 to January 2020 having any of the classical symptomatology as described in the inclusion criteria, were enrolled. Clinical assessment and data collection was followed by statistical analysis after sorting out the patients into two groups.Results: In Group A, the symptoms which turned out non-significant for biochemical thyroid disease were chronic constipation, menorrhagia, pedal edema and pallor. In Group B, the picture was somewhat similar, but importantly, chronic constipation turned out to be significant for hypothyroidism while menorrhagia, pedal edema and pallor were insignificant with actual disease. Overt hypothyroidism was the most common thyroid disorder detected in both the groups.Conclusions: appreciating the variability and importance of clinical symptoms of thyroid disorders helps in correctly diagnosing them, especially in the vulnerable elderly population.

Análise de estrutura interna do Inventário de Depressão Maior (MDI) / Internal structure analysis of the Major Depression Inventory (MDI) / Análisis de estructura interna del Inventario de Depresión Mayor (MDI)

O objetivo do estudo foi avaliar as qualidades psicométricas do Inventário de Depressão Maior (MDI). O MDI foi aplicado em 714 estudantes universitários e em 12 pessoas com diagnóstico de depressão. Realizaram-se análises de estrutura interna via TCT e TRI, bem como confiabilidade, sensibilidade e especificidade. A solução unidimensional foi a mais coerente teoricamente e os parâmetros via TCT adequados, com confiabilidade de 0,89. Já, via TRI, nem todos os parâmetros adequados foram respeitados, tais como índices de infit e outfit, além de categorias de respostas não discriminativas. Os índices de acurácia também demonstraram limitações, principalmente com relação aos falsos negativos (especificidade de 63,9). Assim, sugere-se a realização de novos estudos analisando-se os dados via TRI, bem como um grupo clínico maior, diagnosticados com entrevista estruturada padrão.

The objective of the study was to evaluate the psychometric qualities of the Major Depression Inventory (MDI). The MDI was applied to 714 university students and 12 people diagnosed with depression. Internal structure analyses were performed using TCT and IRT, as well as reliability, sensitivity, and specificity. The one-dimensional solution was the most coherent theoretically and the parameters via suitable TCT, with a reliability of 0.89. Already, via IRT, not all appropriate parameters were respected, such as infit and outfit indexes, as well as categories of non-discriminative responses. Accuracy indexes also showed limitations, especially concerning false negatives (specificity of 63.9). Thus, it is suggested to perform new studies analyzing the data via IRT, as well as a larger clinical group, diagnosed with a standard structured interview.

El objetivo del estudio fue evaluar las calidades psicométricas del Inventario de Depresión Mayor (MDI). El MDI fue aplicado en 714 estudiantes universitarios y en 12 personas con diagnóstico de depresión. Se realizaron análisis de estructura interna vía TCT y TRI, así como confiabilidad, sensibilidad y especificidad. La solución unidimensional fue la más coherente teóricamente y los parámetros vía TCT adecuados, con confiabilidad de 0,89. En cambio, a través de TRI, no se respetaron todos los parámetros adecuados, tales como índices de infit y outfit, además de categorías de respuestas no discriminatorias. Los índices de exactitud también demostraron limitaciones, principalmente con relación a los falsos negativos (especificidad de 63,9). Así, se sugiere la realización de nuevos estudios analizando los datos vía TRI, así como un grupo clínico mayor, diagnosticados con entrevista estructurada estándar.

Relación entre automanejo y síntomas depresivos en personas con diabetes e hipertensión / Relationship between self-management and depressive symptoms in persons with diabetes and hypertension / Relação entre automanejo e sintomas depressivos em pessoas com diabetes e hipertensão

Resumen Introducción: Las personas con diabetes e hipertensión experimentan con mayor frecuencia sintomatología depresiva, lo cual contribuye a un inadecuado automanejo de la enfermedad, que implica tareas como: la toma de la medicación, asistir a las consultas médicas, el conocimiento de signos y síntomas, además de la toma de decisiones. Objetivo: Por lo anterior, el objetivo de este trabajo es identificar la relación entre automanejo en general y sus dimensiones con síntomas depresivos en personas con diabetes e hipertensión. Método: Estudio transversal-correlacional con n=205 pacientes con diagnóstico de diabetes (100) e hipertensión (105). Muestreo no probabilístico por conveniencia. Se utilizó la estadística descriptiva y r de Pearson. Se aplicaron los instrumentos Partners in Health (PIH) y The Patient Health Questionnaire (PHQ-8). Resultados: Se encontró correlación estadísticamente significativa entre la sintomatología depresiva y el automanejo (r=-0.308 ρ<0.001). Discusión y Conclusiones: Se concluye que la sintomatología depresiva se relaciona con el automanejo de la enfermedad de la siguiente manera: a mayor automanejo menor sintomatología de depresión, o a mayor sintomatología depresiva menor automanejo; dicha relación confirma que ambas variables se afectan mutuamente y/o mantienen una relación estrecha.

Abstract Introduction: Persons with diabetes and hypertension frequently suffer from depression as well, a situation which contributes to an inadequate management of the condition in terms of medication, medical consultations, signs, and decision making. Objective: To identify the relationship between general self-management and depression symptoms in persons with diabetes and hypertension. Method: This is a transversal and correlational study with a sample of 205 patients, 100 with a main diagnosis of diabetes, and 105 with a main diagnosis of hypertension. The sampling process was non-probabilistic and by convenience. Descriptive statistics, including Pearson's r were calculated. The Partners in Health (PIH) and Patient Health Questionnaire (PHQ-8) instruments were administered. Results: A statistically significant correlation between depression symptoms and diabetes and hypertension self-management was found (r=-0.308 ρ<0.001). Discussion and conclusions: Depression symptoms were related to how diabetes and hypertension are self-managed in a way that, the more self-management, the less depression symptoms, or the more depression symptoms, the less self-management.

Resumo Introdução: As pessoas com diabetes e hipertensão experimentam com maior frequência a sintomatologia depressiva, o qual contribui a um inadequado automanejo da doença, que envolve tarefas como: a toma da medicação, assistir às consultas médicas, o conhecimento de signos e sintomas, além da toma de decisões. Objetivo: Pelo anterior, o objetivo deste trabalho é identificar a relação entre automanejo em geral e suas dimensões com sintomas depressivos em pessoas com diabetes e hipertensão. Método: Estudo transversal-correlacional com n=205 pacientes com diagnóstico de diabetes (100) e hipertensão (105). Amostragem não probabilística por conveniência. Utilizou-se a estatística descritiva e r de Pearson. Aplicaram-se os instrumentos Partners in Health (PIH) e The Patient Health Questionnaire (PHQ-8). Resultados: Encontrou-se correlação estatisticamente significativa entre a sintomatologia depressiva e o automanejo (r=-0.308 ρ<0.001). Discussão e Conclusões: Conclui-se que a sintomatologia depressiva relaciona-se com o automanejo da doença da seguinte maneira: a maior automanejo, menor sintomatologia de depressão, ou a maior sintomatologia depressiva, menor automanejo; esta relação confirma que ambas variáveis afetam-se mutuamente e/ou mantem uma relação estreita.

Tratamientos Basados en Mindfulness en la Población Infanto-Juvenil con Sintomatología Ansiosa. Una Revisión Sistemática / Treatments Based on Mindfulness in the Child-Youth Population with Anxious Symptomatology. A Systematic Review / Tratamentos Baseados na Atenção Plena na População Infantil-Jovem com Sintomatologia Ansiosa. Uma revisão sistemática

Resumen: El objetivo de la presente investigación es conocer los efectos de los tratamientos basados en Mindfulness en la población infanto-juvenil con sintomatología ansiosa y/o trastorno de ansiedad a través de una revisión sistemática de la literatura disponible en diversas bases de datos entre enero del 2007 a marzo del 2017. En la búsqueda se encontró un aumento significativo de publicaciones que abordan la temática de Mindfulness. Sin embargo, en la población infanto-juvenil con sintomatología ansiosa y/o trastorno de ansiedad se obtuvo un número reducido de investigaciones. Encontrándose dos revisiones sistemáticas, cuatro revisiones narrativas y cinco ensayos clínicos. El escaso número de publicaciones en esta temática hace difícil dimensionar los efectos del tratamiento de Mindfulness en esta población con sintomatología ansiosa y/o trastorno de ansiedad. Se requiere de más ensayos clínicos controlados para poder establecer su relevancia como herramienta terapéutica para la disminución de la ansiedad en la población infanto-juvenil.

Abstract: The aim of this study is to explore the effects of treatments based on Mindfulness in childhood and adolescent population with anxious symptomatology and/or anxiety disorder through a systematic review of the available literature in various databases between January 2007 to March 2017. In the search we found a significant increase in publications that address the subject of Mindfulness. However, in the child and adolescent population with anxious symptomatology and/or anxiety disorder, a number of reduced investigations were found. Finding two systematic reviews, four narrative reviews and five clinical trials. The small number of publications on this subject makes it difficult to measure the effect on Mindfulness treatment in this population with anxious symptomatology and/or anxiety disorder. More controlled clinical trials are required in order to establish its relevance as a therapeutic tool for the reduction of anxiety with the child and adolescent population.

Resumo: O objetivo desta pesquisa é conhecer os efeitos de tratamentos baseados no Mindfulness na população de crianças e adolescentes com sintomatologia ansiosa e/ou disturbio de ansiedade por meio de uma revisão sistemática da literatura disponível em várias bases de dados entre janeiro de 2007 a março de 2017. Na pesquisa encontramos um crescimento significativo em publicações que abordam o tema da Atenção Plena. Não obstante, na população de crianças e adolescentes com sintomatologia ansiosa e/ou disturbio de ansiedade, foi encontrado um pequeno número de investigações. Encontraram-se duas revisões sistemáticas, quatro revisões narrativas e cinco ensaios clínicos. O pequeno número de publicações sobre o assunto dificulta a medição dos efeitos do tratamento do Mindfulness nessa população com sintomatologia ansiosa e/ou disturbio de ansiedade. Mais ensaios clínicos controlados são necessários para estabelecer a sua relevância como uma ferramenta terapêutica para a redução da ansiedade na população infanto-juvenil.

Evidências de validade para a escala Baptista de depressão versão hospital-ambulatório (EBADEP-HOSP-AMB) / Validity evidence for the Baptista developmental scale hospital-ambulatory version (EBADEP-HOSP-AMB) / Evidencias de validez para la escala Baptista de depresión versión hospital-ambulatorio (EBADEP-HOSP-AMB)

O objetivo do estudo foi buscar evidências de validade baseadas na relação com variáveis externas para a Escala Baptista de Depressão Versão Hospital-Ambulatório (EBADEP-HOSP-AMB). Participaram 210 pacientes renais crônicos em hemodiálise, com idades entre 18 e 82 anos (M=53,40; DP=14,40), sendo 112 (53,3%) do sexo masculino. Foram aplicados um questionário sociodemográfico/saúde, juntamente com a EBADEP-HOSP-AMB, a Escala Hospitalar de Ansiedade e Depressão (HADS) e a Escala de Pensamentos Depressivos (EPD). As aplicações ocorreram de forma individual durante as sessões de hemodiálise. Foi verificada a relação entre os instrumentos além de possíveis diferenças de média em função das variáveis sociodemográficas. Os principais resultados indicaram correlações significativas de magnitudes moderadas a altas entre os instrumentos. Também foi observado que as mulheres e aqueles que relataram ter diagnóstico de depressão obtiveram escores mais elevados na maioria das escalas apresentando mais sintomatologia depressiva e pensamentos depressivos, bem como ansiedade (AU).

The purpose of the study was to seek validity evidence based on the relationship with external variables for the Hospital-Ambulatory Depression Baptist Scale (EBADEPHOSP-AMB). A total of 210 chronic kidney patients undergoing hemodialysis, aged 18-82 years (M=53.40, SD=14.40), 112 (53.3%) males participated. A sociodemographic/health questionnaire was applied, along with the EBADEP-HOSPAMB, the Hospital Anxiety and Depression Scale (HADS) and the Depressive Thoughts Scale (EPD). The applications occurred individually during the hemodialysis sessions. The relationship between the instruments was verified, besides possible differences of mean according to the sociodemographic variables. The main results indicated significant correlations of moderate to high magnitudes between the instruments. It was also observed that women and those who reported having a diagnosis of depression scored higher on most scales presenting more depressive symptomatology and depressive thoughts as well as anxiety (AU).

El objetivo del estudio fue buscar evidencias de validez basadas en la relación con variables externas para la Escala Baptista de Depresión Versión Hospital-Ambulatorio (EBADEP-HOSP-AMB. Participaron un total de 210 pacientes renales crónicos en hemodiálisis, con edades entre 18 y 82 años (M=53,40; DP=14,40), siendo 112 (53,3%) del sexo masculino. Se aplicó un cuestionario sociodemográfico / salud, junto con EBADEP-HOSP-AMB, la Escala Hospitalaria de Ansiedad y Depresión (HADS) y la Escala de Pensamientos Depresivos (EPD). Los cuestionarios fueron aplicados de forma individual durante las sesiones de hemodiálisis. Se verificó la relación entre los instrumentos además de posibles diferencias de promedio en función de las variables sociodemográficas. Los principales resultados indicaron correlaciones significativas de magnitudes moderadas a altas entre los instrumentos. También se observó que las mujeres y aquellos que reportaron tener diagnóstico de depresión obtuvieron puntuaciones más altas en la mayoría de las escalas presentando más sintomatología depresiva y pensamientos depresivos, así como ansiedad (AU.

Sintomatologia depressiva no termo da gestação, em mulheres de baixo risco / Depressive symptomatology at full-term pregnancy in low risk women

RESUMO Objetivos Calcular a prevalência de sintomatologia depressiva pré-natal em grávidas de baixo risco, no termo da gestação, avaliar seus preditores e desfechos materno-fetais. Para tal, avaliar-se-á a aplicabilidade da Escala de Rastreio de Depressão Pós-Parto (PDSS 24) nessa fase da gravidez. Métodos A PDSS 24 e um questionário sociodemográfico, psicossocial e médico (antecedentes obstétricos e patológicos) foram autoaplicados a 403 grávidas (37-40 semanas de gestação), com idade média de 30,5 anos (DP = 4,67). Por meio do processo clínico, foram recolhidos dados de resultados materno-fetais. Resultados A PDSS 24 possui propriedades psicométricas adequadas para a deteção de sintomatologia depressiva pré-natal. A prevalência de sintomatologia depressiva pré-natal foi de 41,7%. Grávidas com níveis de escolaridade inferiores, não casadas, cuja gravidez não foi planejada e com antecedentes de acontecimentos de vida significativos apresentam risco duas vezes superior de sintomatologia depressiva no período pré-natal. Grávidas cujo apoio social percebido ao longo da gravidez não correspondeu ao desejado e com história prévia de depressão apresentam cerca de três vezes maior risco sintomatologia depressiva no período pré-natal. Para desfechos materno-fetais (pré-eclâmpsia, restrição de crescimento fetal, Apgar 1º/5º minuto, tipo de parto, percentil de peso, oligoâminos e necessidade de cuidados intensivos), as diferenças foram não significativas. Conclusão O rastreio da depressão pré-natal deve ser realizado na gravidez. Porém, no termo da gestação o uso da PDSS 24 como ferramenta de deteção de sintomatologia depressiva deve ser feito com cautela. A elevada prevalência de sintomas relacionados com o sono nessa fase da gestação pode conduzir ao sobre diagnóstico, usando a PDSS 24.

ABSTRACT Objectives The aims of the study were to estimate the prevalence of depressive symptomatology in full-term pregnancy (low risk), evaluate their predictors and maternal-fetal outcomes. To this end, the applicability of Postpartum Depression Screening Scale (PDSS 24) will be evaluated, at full-term pregnancy. Methods PDSS 24 and a sociodemographic, psychosocial, pathological and obstetrical background questionnaire were self-administered to 403 pregnant women (37-40 weeks gestation), with a mean age of 30.5 years (SD = 4.67). Data from maternal, fetal and neonatal outcomes were collected from the patient clinical process. Results PDSS 24 revealed adequate psychometric properties to screening depressive symptomatology in full-term pregnancy. The prevalence of depressive symptomatology was 41.7%. Pregnant women with lower study levels, who weren't married, whose pregnancy was unplanned and with a previous history of significant life events present twice the risk to present depressive symptomatology. Pregnant women who hadn't received the desired social support in pregnancy and with a history of depression present about a 3-fold increased risk to present depressive symptomatology. For maternal-fetal outcomes (pre-eclampsia, fetal growth restriction, Apgar score at 1st/5th minute, type of delivery, weight percentile, oligohydramnios and need for neonatal intensive care), the differences were not significant. Conclusion Screening for prenatal depression should be conducted during pregnancy. However, in full-term pregnancy women, the use of PDSS 24 as a screening tool for depressive symptomatology should be done with caution. The high prevalence of sleep-related symptoms, in full-term pregnancy, may lead to overdiagnosis, using PDSS 24.