Single-center "Argentine" analysis of post-transplant lymphoproliferative disorders: incidence, histopathological characteristics and EBV status

ABSTRACT Introduction: Post-transplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of lymphoid proliferations occurring after solid organ or bone marrow transplantation. The primary aims of our study were to characterize cumulative incidence of PTLDs, clinical and pathological features according to the Epstein-Barr virus (EBV) status and survival. Methods: This was a retrospective cohort study on adult and pediatric patients, from January 2001 to December 2017. The cumulative incidence of PTLD was calculated by analyzing all the patients transplanted at our hospital, based on the database of the Organ Donation and Ablation Authority of Argentina (INCUCAI). The Kaplan-Meier method was used to plot the survival. Results: Fifty-eight cases of biopsy-confirmed PTLD were identified and 12 cases of clinical data were incomplete and these patients were excluded. The median age at the time of the PTLD diagnosis was 17.5 years (interquartile range [IQR] 9 - 57). The median interval between transplant and PTLD diagnosis was 39 months (IQR 9 - 113). The most commonly transplanted organ was the liver (24 cases, 52.2%), followed by kidney (20 cases, 43.5%). The Epstein-Barr encoding region in situ hybridization (EBER ISH) was positive in 29 (69.8%) of the 43 evaluable biopsies. The PTLD cumulative incidence was 1.84% (95%CI 1.77 - 1.91) for solid organ and 0.84% (95%CI 0.48 - 1.2) for bone marrow transplant patients. The overall survival rate at 5 years was 0.77 (95%CI 0.61 - 0.87). Subgroups by the EBV EBER status, transplant type, PTLD subtype and age group (adult vs. pediatric) showed no statistically significant association with the overall survival. Conclusion: The PTLD incidence was similar to that of previous series and the EBER did not appear as a relevant factor in our patient survival.

Esquemas desadaptativos Iniciales como predictores de conductas disfuncionales: una revisión de la literatura / Esquemas iniciais desadaptativos como preditores de comportamentos disfuncionais: uma revisão de literatura / Early maladaptive schemes as predictors of dysfunctional behaviors: a literature review

Este artigo pretende verificar a quantidade de pesquisas publicadas no mundo nos últimos cinco anos e sua predição para com o comportamento humano. Foram encontrados 75 artigos nas bases de dados Scielo, Medline e Lilacs, a través de uma busca utilizando descritores em português e na língua inglesa no Portal Periódicos.capes. Os resultados apontaramque os estudos encontrados tiveram relação aos transtornos da personalidade, referindode forma direta a comportamentos relacionados aos esquemas desadaptativos como preditores dos transtornos da personalidade. Outros temas considerados foram o suicídio, o divórcio, a violência conjugal, patologias orgânicas e/ou dor crônica, a parentalidade,comportamentos erráticos, saúde e validação de escalas. Conclui-se que esta revisão tem sua importância na análise criteriosa dos estudos sobre os EIDs e sua relação com a personalidade, já que a teoria cognitiva traz a priori que os comportamentos disfuncionais estão relacionados com os Esquemas Iniciais Desadaptativos AU

Este artículo tiene como objetivo verificar la cantidad de investigaciones publicadas en el mundo en los últimos cinco años y su predicción para el comportamiento humano. Se encontraron un total de 75 artículos en las bases de datos Scielo, Medline y Lilacs, a través de una búsqueda con descriptores en portugués e inglés en el Portal Periódicos.capes. Los resultados mostraron que los estudios encontrados estaban relacionados con los trastornos de personalidad, refiriéndose directamente a conductas relacionadas con esquemas desadaptativos como predictores de trastornos de personalidad. Otros temas considerados fueron suicidio, divorcio, violencia conyugal, patologías orgánicas y/o dolor crónico, crianza, comportamiento errático, salud y validación de escalas. Se concluye que esta revisión es importante en el análisis cuidadoso de los estudios sobre las EID y su relación con la personalidad, ya que la teoría cognitiva muestra a priori que las conductas disfuncionales están relacionadas con los Esquemas Desadaptativos Iniciales AU

This article aims to verify the amount of research published in the world in the last five years and its prediction for human behavior. A total of 75 articles were found in the Scielo, Medline and Lilacs databases, through a search using descriptors in Portuguese and English on the Portal Periódicos.capes. The results showed that the studies found were related topersonality disorders, referring directly to behaviors related to maladaptive schemas as predictors of personality disorders. Other topics considered were suicide, divorce, marital violence, organic pathologies and/or chronic pain, parenting, erratic behavior, health and validation of scales. It is concluded that this review is important in the careful analysis of studies on EIDs and their relationship with personality, since the cognitive theory shows a priori that dysfunctional behaviors arerelated to Initial Maladaptive Schemas AU

Migração em tempos de covid-19: impactos e estratégias de enfrentamento / Migration in times of covid-19: effects and coping strategies / Migración en tiempos del covid-19: impactos y estrategias de afrontamiento

Em 2020, o mundo enfrentou uma grave emergência de saúde pública devido à pandemia de COVID-19, que impactou significativamente a mobilidade humana e a vida cotidiana de milhares de imigrantes ao redor do mundo. Este artigo fez uso de entrevistas online e por telefone com imigrantes que chegaram ao Brasil a partir de 2016, para identificar as estratégias de enfrentamento adotadas durante a pandemia. Foi realizada uma análise transversal das entrevistas com o auxílio do software Atlas.ti 9, usando a técnica sistemática de categorização iterativa. Com base em uma perspectiva sociocultural em psicologia, o artigo introduz os impactos iniciais da pandemia em diferentes esferas da vida cotidiana desses imigrantes e apresenta as estratégias mobilizadas para restaurar continuidades funcionais e relacionais em um momento no qual as rupturas provocadas pela migração e pela pandemia se sobrepõem. Entre outros, podese identificar como os entrevistados ativaram rapidamente as redes sociais locais e transnacionais virtualmente, mobilizando competências e habilidades aprendidas durante a migração.(AU)

In 2020, the world faced a serious public health emergency due to the COVID-19 pandemic, which has significantly impacted human mobility and the daily lives of thousands of immigrants around the world. This article uses online and telephone interviews conducted with migrants who arrived in Brazil in 2016, to identify coping strategies employed during the pandemic. A transversal analysis of all interviews was conducted with the aid of the software Atlas.ti 9, using a systematic approach of iterative categorization. From a sociocultural perspective in psychology, the article introduces the initial impacts of the pandemic in different spheres of everyday life of these immigrants. With this everyday context, we present the strategies mobilized by immigrants to restore functional and relational continuities at a moment in which the ruptures caused by migration and the pandemic overlap. In particular, we identify how interviewees rapidly activated local and transnational social networks virtually, mobilizing skills learnt during migration.(AU)

En 2020, el mundo se enfrentó a un grave estado de emergencia en salud pública debido a la pandemia del COVID-19, que impactó significativamente la movilidad humana y la vida cotidiana de miles de inmigrantes en todo el mundo. Este artículo realizó entrevistas en línea y por teléfono con inmigrantes quienes llegaron a Brasil a partir de 2016, con el fin de identificar sus estrategias de afrontamiento adoptadas durante la pandemia. Se realizó un análisis transversal de las entrevistas con la ayuda del software Atlas.ti 9, utilizando la técnica sistemática de categorización iterativa. Desde una perspectiva sociocultural en Psicología, este artículo expone los impactos iniciales de la pandemia en diferentes ámbitos de la vida cotidiana de estos inmigrantes y presenta las estrategias movilizadas para restaurar las continuidades funcionales y relacionales en un momento en que se superponen las rupturas causadas por la migración y la pandemia. Entre otros aspectos, se puede identificar cómo los entrevistados activaron virtualmente las redes sociales locales y transnacionales movilizando habilidades y destrezas aprendidas durante la migración.(AU)

Pre-and post-donation ferritin level of blood donors attending University of Calabar Teaching Hospital, Donor Clinic in Southern Nigeria

While trying to save the patient via blood transfusion, the safety of the blood donor is paramount. This study evaluated the pre-and post-donation ferritin and packed cell volume (PCV) of donors attending University of Calabar Teaching Hospital.Method: The study adopted descriptive longitudinal approach. A total of 18 donors with age range of 18 ­48years were enrolled and followed up for 30 days post-donation. The serum ferritin was analyzed using ELISA method while the PCV was analyzed using the microhematocrit method. Difference between means was performed using repeated measure ANOVA while post hoc was done using Bonferroni adjustment. Prediction of return to baseline values were performed using logistic regression. Alpha value was placed at 0.05 There was a decline in ferritin and packed cell volume from pre-to post-donation. The decline in ferritin was imminent until day 14 when recovery was initiated. Significant difference was observed between the pre-donation ferritin and the rest of the days except day 30. There was also a decline in PCV from pre-donation all through with recovery noticeable after day 7. The PCV of the pre-donation was only comparable to the day 30 post-donation. Approximately 5.6% (n=1) of the subjects was iron deficient pre-donation.Approximately 25% (n=4) of the subject have returned to baseline PCV while 0% of the subjects have returned to baseline ferritin at day 30 post-donation.Conclusion: For the safety of the donor, donation interval should be widened, and iron supplement followed up

Depression and Burnout among Health Extension Workers in Ethiopia: A Cross-Sectional Study

BACKGROUND: Depression and burnout are common among healthcare workers (HCWs) and negatively affect their well being and the quality of the service they provide. However, the burden of depression and burnout among health extension workers (HEWs) in Ethiopia and their relationship has not been documented well. The objective of this study was to estimate the prevalence of depression and burnout among HEWs in Ethiopia and to investigate the relationship between these conditions. MATERIALS AND METHODS: We used a cross-sectional study design and collected data from 584 rural and 581 urban HEWs in Ethiopia, as part of the 2019 national health extension program assessment. The Patient Health Questionnaire (PHQ-9) and Burnout Self-Test were used to screen HEWs for depression and burnout, respectively. We used descriptive statistics to estimate the magnitude of depression and burnout, and logistic regression to examine their relationship. RESULT: Based on PHQ-9 cutoff scores of 10, the prevalence of major depression was 16.5% among rural and 8.9% among urban HEWs, whereas burnout risk was 39.8% among rural and 12.6% among urban HEWs. The odds of having depression among HEWs with burnout risk was relatively higher compared to those without burnout risk [For rural HEWs, the adjusted odds ratio (AOR) is 11.88 at a 95% confidence interval (CI; 5.27, 26.80), and for urban HEWs, the AOR is 11.49 at a 95% CI (5.35, 24.63)]. CONCLUSION: The prevalence of depression and burnout is high among HEWs in Ethiopia, with a significant rural­urban difference, and burnout is a significant predictor of depression. Mental health interventions that enable prevention, early detection, and management are needed especially for rural HEWs who are in charge of preventive health service delivery for the disadvantaged rural communities

Construcción de subjetividad en pandemia. Observaciones en la clínica con adolescentes / Construction of subjectivity in pandemic. Observations in the clinic with adolescents / Construction de la subjectivité en pandémie. Observations en clinique avec des adolescents / Construção da subjetividade na pandemia. Observações na clínica com adolescentes

Para pensar las adolescencias hoy, se requiere considerar que la pandemia en la que estamos todos inmersos, nos obliga a situar la construcción de la subjetividad adolescente en estos últimos años, en un acontecimiento inédito en la vida de todos. Las transformaciones que produjo la pandemia de coronavirus en la construcción de subjetividades de los que habitamos este mundo, adquieren categoría de un cambio radical, abrupto y planetario. Este trabajo revisa algunas condiciones subjetivantes como las tecno-culturas, la lógica de la simultaneidad, trauma, algunos síntomas específicos como consecuencia del encierro y la incertidumbre generalizada AU

In order to think about adolescence today, it is necessary to consider that the pandemic in which we are all immersed forces us to situate the construction of adolescent subjectivity in these last two years as an unprecedented event in everyone's life.The transformations that the coronavirus pandemic produced in the construction of subjectivities of those of us who inhabit this world, acquire the category of a radical, abrupt and planetary change. This work reviews some conditions such as techno-cultures, the logic of simultaneity, trauma and some specific symptoms as a consequence of confinement and generalized uncertainty AU

Pour penser l'adolescence aujourd'hui, il faut considérer que la pandémie laquelle nous sommes tous plongés nous oblige à situer la construction de la subjectivité adolescentde ces deux dernières années comme un événement inédit dans la vie de chacun. Les transformations que la pandémie de coronavirus a produites dans la construction des subjectivités de ceux d'entre nous qui habitent ce monde, acquièrent la catégorie d'un changement radical, brusque et planétaire. Ce travail passe en revue certaines conditions subjectivantes telles que les techno-cultures, la logique de la simultanéité, le traumatisme, certains symptômes spécifiques comme conséquence de l'enfermement et l'incertitude généralisée AU

Para pensar a adolescência hoje, é preciso considerar que a pandemia em que todos estamos imersos nos obriga a situar a construção da subjetividade adolescente nos últimos anos, em um evento sem precedentes na vida de todos. As transformações que a pandemia do coronavírus produziu na construção das subjetividades de nós que habitamos este mundo, adquirem a categoria de mudança radical, abrupta e planetária. Este trabalho revisa algumas condições subjetivantes como as tecnoculturas, a lógica da simultaneidade, o trauma, alguns sintomas específicos consequência do confinamento e da incerteza generalizada AU

Qualidade de vida e risco de depressão em idosos institucionalizados / Quality of life and risk of depression in institutionalized elderly / Calidad de vida y riesgo de depresión en personas institucionalizadas

Objetivo: verificar a prevalência de sintomas depressivos e associação com qualidade de vida em idosos institucionalizados. Métodos: estudo descritivo realizado com idosos de duas instituições de longa permanência do Paraná. Os dados foram coletados entre junho e setembro de 2018, mediante entrevista estruturada, utilizando o The World Health OrganizationQualityof Life (WHOQOL ­ bref) e a Escala de Depressão Geriátrica. Os dados foram analisados por meio de estatística descritiva e inferencial no software R. Resultados: a maioria dos idosos (62%) tinha algum grau de sintomas depressivos - leve ou severo. A qualidade de vida apresentou correlação com características sociodemográficas, condição de saúde, estilo de vida e presença de sintomas depressivos. Conclusão: a prevalência de sintomas depressivo na amostra estudada foi alta, o que indica a necessidade de maior atenção para a saúde mental de idosos residentes em instituições de longa permanência

Objective: to verify the prevalence of depressive symptoms and to evaluate the quality of life in institutionalized elderly. Methods: descriptive study carried out with elderly people from two long-term institutions in Paraná. Data were collected between June and September 2018, through a structured interview, using The World Health Organization Quality of Life (WHOQOL ­ bref ) and the Geriatric Depression Scale - GDS. The data were analyzed using descriptive and inferential statistics in the R software. Results: most of the elderly (62%) had some degree of depressive symptoms ­ mildor severe. Quality of life was correlated with sociodemographic characteristics, health condition, life style and presence of depressives ymptoms. Conclusion: the prevalence of depressive symptoms in the sample studied was high, which indicates the need for greater attention to the mental healt hof elderly people living in long-term institutions

Objetivo: verificar La prevalencia de sintomas depresivos y evaluar La calidad de vida em ancianos institucionalizados. Métodos: Estudio descriptivo realizado con personas mayores de dos instituciones de larga duración en Paraná. Los datos se recopilaron entre junio y septiembre de 2018, através de una entrevista estructurada, utilizando La Calidad de vida de La Organización Mundial de La Salud (WHOQOL) y la Escala de depresión geriátrica (GDS). Los datos se analizaron mediante estadísticas descriptivas e inferencial esen el software R. Resultados: La mayoría de losancianos (62%) tenían algún grado de sintomas depresivos, leves o graves. La calidad de vida se correlaciono com las características sociodemográficas, el estado de salud, el estilo de vida y la presencia de sintomas depresivos. Conclusión: la prevalencia de sintomas depresivos em La muestra estudiada fue alta, lo que indica La necesidad de una mayor atención a La salud mental de las personas mayores que viven em instituciones a largo plazo

Diseño y validación de un Protocolo de Atención Psicológica para la ideación suicida / Design and validation of a psychological attention protocol for suicidal ideation

Resumen La cifra de personas que presentan o han presentado alguna conducta suicida ha aumentado significativamente en Colombia desde el año 2014 al 2019, convirtiendo la conducta suicida en una problemática de salud pública; sin embargo, es un concepto amplio, que abarca diferentes tipos de conductas, por esto es necesario establecer un protocolo de atención para estandarizar las acciones del terapeuta o personas que se desempeñan en los servicios prestadores de salud. El presente artículo tiene como objetivo describir cómo se realizó el diseño y la validación de un protocolo de atención psicológica para atención en ideación suicida de los consultantes que asisten a un centro de atención psicológica de una institución universitaria de la ciudad de Bogotá. Se realizó un estudio cuantitativo, de tipo instrumental, el cual implicó: a) el diseño de la ruta de atención, situaciones que activan el protocolo y el módulo de atención en crisis; b) la participación de 10 jueces expertos con el fin de realizar la validación por contenido de todos los componentes del protocolo de atención psicológica. Los resultados arrojaron que el diseño es pertinente, suficiente y relevante para la problemática que se buscó abordar.

Abstract Currently, the number of people who present or have presented some suicidal behavior has increased significantly in Colombia from 2014 to 2019, making suicidal behavior a public health problem. However, it is abroad concept that covers different types of behavior, so it is necessary to establish a protocol of care to standardize the actions of the therapist and/or people who work in health care services. The present article aims to describe how a psychological care protocol was designed and validated for the care of suicidal ideation of consultants who attend a psychological care center at a university institution in the city of Bogotá. A quantitative, instrumental study was carried out, which involved: a) designing the care route, situations that activate the protocol and the crisis care module; b) the participation of 10 expert judges to carry out the validation of the content of all the components of the psychological care protocol. The results showed that the design of the care protocol is pertinent, sufficient, and relevant to the problem to be addressed.

COVID-19 y su asociación con síntomas depresivos en población española / COVID-19 and its association with depressive mood symptoms in the Spanish Population

RESUMEN. Introducción: la emergencia sanitaria por el COVID-19 ha generado una conmoción mundial que conlleva una serie de problemáticas relacionadas con la salud, los factores psicosociales y la situación económica. Objetivo: evaluar el efecto del confinamiento en el ánimo depresivo en población residente en España mayor de 18 años durante el estado de alarma provocada por la pandemia de la COVID-19, analizando, además, la posible incidencia de las variables sexo, edad, tamaño de la vivienda e ingresos económicos. Material y Métodos: diseño transversal, descriptivo y correlacional con metodología de carácter cuantitativo. El acceso a la muestra fue no probabilístico a través de la técnica bola de nieve. Para evaluar la condición de ánimo depresivo se utilizó la escala CES-D. Para recopilar los datos relacionados con el sexo, la edad, el tamaño de vivienda y la situación económica, se crearon preguntas ad hoc en la propia encuesta. Resultados: las mujeres presentan valores de ánimo depresivo superiores a los hombres. Además, los valores de ánimo depresivo son mayores cuanto menor es la edad. Las personas que residen en viviendas con un tamaño menor, presentan valores de ánimo depresivo superiores respecto a las personas que viven en residencias con superficies mayores. A su vez, las personas con peores condiciones económicas perciben mayores niveles de ánimo depresivo. Conclusiones: los resultados indican que los síntomas de ánimo depresivo y las consecuencias psicosociales en la población española durante el confinamiento, se encuentran condicionadas por el sexo, la edad, el tamaño de la vivienda y la situación económica(AU)

ABSTRACT Introduction: Health emergency due to the COVID-19 pandemic has generated a global commotion, leading to a series of problems related to health, psychosocial factors and economic situation. Objective: To evaluate the effect of confinement on depressive mood in Spanish residents who are over 18 years old during the state of emergency which was declared due to the COVID-19 pandemic. Additionally, this paper aims to analyze the possible impact of some variables such as sex, age, size of dwelling and income. Materials and Methods: Cross-sectional, descriptive and correlational design with quantitative methodology. Access to the sample was based on a non-probabilistic sampling through snowball technique. CES-D scale was used to evaluate the state of depressive mood. In order to collect data related to sex, age, size of dwelling and economic situation, ad hoc questions were included in the survey. Results: Women presented higher values of depressive mood than men. Furthermore, depressive mood values are higher in younger individuals. People who live in smaller dwellings showed higher values of depressive mood compared to those who live in larger dwellings. Similarly, individuals with less favorable economic conditions perceive higher levels of depressive mood. Conclusions: The results show that depressive mood symptoms and their psychosocial consequences in the Spanish population during confinement are conditioned by sex, age, dwelling size and economic situation(AU)

Ansiedade cardíaca no perioperatório de cirurgias de revascularização do miocárdio e de correção de valvopatias / Cardiac anxiety in the perioperative period of coronary artery bypass grafting and valvular heart disease surgeries

Objetivo: Comparar os sintomas de Ansiedade Cardíaca (AC) em pacientes submetidos à cirurgia cardíaca no pré-operatório, no dia da alta hospitalar e no primeiro retorno, e investigar a associação desses sintomas com variáveis sociodemográficas, clínicas e com os sintomas de ansiedade e depressão. Método: Estudo observacional analítico, de coorte prospectivo, realizado em um hospital universitário do interior paulista. Uma amostra consecutiva e não probabilística foi constituída por pacientes de ambos os sexos, maiores de 18 anos, submetidos a Cirurgia de Revascularização do Miocárdio (CRM) e cirurgias para correção de valvopatia. Para a avaliação dos sintomas de AC foi utilizado o "Questionário de Ansiedade Cardíaca". A coleta de dados foi realizada por meio de entrevistas individuais e consulta aos prontuários dos participantes em três momentos: T0 (pré-operatório), T1 (pós-operatório, no dia da alta hospitalar) e T2 [primeiro retorno, que ocorre 14 dias (± 7 dias) após alta hospitalar]. Para compararmos os sintomas de AC nos três tempos, utilizamos o teste de Friedman e para investigarmos a correlação dos sintomas de AC com os sintomas de ansiedade e depressão, utilizamos o teste de Correlação de Spearman. O nível de significância foi de 5%. Resultados: Participaram do estudo 92 pacientes, sendo 34 submetidos à CRM e 58 a correção cirúrgica de valvopatia. Com relação aos pacientes submetidos a CRM, a média de idade encontrada foi de 62,4 anos, maioria do sexo masculino (64%) e com companheiro (67,6%). Os valores dos postos dos sintomas de AC total foram maiores no dia da alta quando comparados com o préoperatório, assim como os sintomas de AC no dia do primeiro retorno quando comparados com o pré-operatório. Pacientes idosos apresentaram maiores escores de AC no pré-operatório. Quanto aos sintomas de ansiedade, foi encontrada correlação moderada com os sintomas de AC nos três tempos. Já nos pacientes submetidos a correção cirúrgica de valvopatia, a média de idade encontrada foi de 54,4 anos, maioria do sexo feminino (51,7%) e com companheiro (70,7%). Os valores dos postos dos sintomas de AC total foram maiores no primeiro retorno quando comparados com o pré-operatório. Pacientes inativos no pré-operatório apresentaram maiores escores de AC. Encontramos fraca correlação da AC dos pacientes com sintomas de ansiedade no pré-operatório e correlação moderada com os sintomas de depressão no préoperatório. Conclusão: Pacientes submetidos à CRM apresentaram maior sintomatologia de AC no dia da alta e no primeiro retorno quando comparados com o pré-operatório, e quanto mais sintomas de AC, mais sintomas de ansiedade nos três tempos estudados. Pacientes idosos apresentaram maior sintomatologia de AC. Os pacientes submetidos à correção de valvopatias apresentaram maior sintomatologia de AC no primeiro retorno quando comparada com o préoperatório, e quanto mais sintomas de AC no pré-operatório, mais sintomas de ansiedade e depressão. Pacientes inativos apresentaram maior sintomatologia de AC.

Objective: To compare the symptoms of Cardiac Anxiety (CA) in patients who underwent cardiac surgery preoperatively, on the day of hospital discharge and on the first return, and investigate the association of these symptoms with sociodemographic and clinical variables and with the symptoms of anxiety and depression. Method: Analytical observational study, with prospective cohort, held in a university hospital in the countryside of São Paulo. A consecutive and non-probabilistic sample consisted of patients of both genders, over 18 years old, who underwent Coronary Artery Bypass Grafting (CABG) and surgeries for correction of valvular heart disease. The "Cardiac Anxiety Questionnaire" was used to assess the symptoms of CA. Data collection took place through individual interviews and consultation of the participants' medical records in three moments: T0 (preoperative), T1 (postoperative, on the day of hospital discharge) and T2 [first return, which happens 14 days (± 7 days) after hospital discharge]. To compare the symptoms of CA in the three stages, we used the Friedman's test; and, to investigate the correlation of the symptoms of CA with the symptoms of anxiety and depression, we used the Spearman's Correlation test. The level of significance was 5%. Results: The study was attended by 92 patients, 34 underwent CABG and 58 surgical correction of valvular heart disease. Regarding patients who underwent CABG, the average age found was 62.4 years, mostly male (64%) and with a partner (67.6%). The presented values of the total symptoms of CA were higher on the day of discharge when compared to the preoperative period, as well as the symptoms of CA on the day of the first return when compared to the preoperative period. Elderly patients presented higher preoperative scores of CA. Regarding the symptoms of anxiety, we found a moderate correlation with the symptoms of CA in the three moments. As for the patients who underwent the surgical correction of valvular heart disease, the average age found was 54.4 years, mostly female (51.7%) and with a partner (70.7%). The presented values of the total symptoms of CA were higher in the first return when compared to the preoperative period. Preoperative inactive patients presented higher scores of CA. We found a weak correlation of CA in patients with symptoms of anxiety in the preoperative period and a moderate correlation with symptoms of depression in the preoperative period. Conclusion: Patients who underwent CABG presented a greater number of symptoms of CA on the day of discharge and on the first return when compared with the preoperative period; and the more symptoms of CA, the more symptoms of anxiety in the three studied periods. Elderly patients presented a greater number of symptoms of CA. Patients who underwent correction of valvular diseases presented a greater number of symptoms of CA in the first return when compared to the preoperative period; and the more symptoms of CA in the preoperative period, the more symptoms of anxiety and depression. Inactive patients presented a greater number of symptoms of CA.

Estigmatización social en el ámbito escolar generada por un diagnóstico psicológico / Social stigmatization in the school field generated by a psychological diagnosis

La presente investigación surge de la pregunta por la estigmatización social en el ámbito escolar, generada por un diagnóstico psicológico. El contexto educativo es escenario de diversas dinámicas que influyen en el proceso de desarrollo de los estudiantes, allí se viven etapas de transición como el paso de primaria a bachillerato, en un período de la vida en el cual el adolescente está en plena construcción de su identidad. Es una etapa de adaptación al entorno, siendo éste un período de vulnerabilidad que puede ser afectado significativamente cuando además, el estudiante lleva consigo un diagnóstico psicológico que puede generar estigmatización social. Esta investigación se llevó a cabo a partir de un rastreo teórico y un estudio de caso único, en el cual se le realizó una entrevista a un estudiante con un diagnóstico psicológico establecido, otra a su madre, una a un docente y finalmente a dos psicólogos de la institución educativa. Se lograron identificar las categorías de diagnóstico, sujeto escolar e identidad en relación a la estigmatización; y a partir de un trabajo riguroso de rastreo y análisis, se concluyó que tener un diagnóstico psicológico sí está altamente relacionado con la estigmatización social y la rotulación por parte de otras personas, lo cual tiene implicaciones importantes en el desarrollo psicosocial de la persona estigmatizada, generando repercusiones negativas como baja autoestima, inseguridad, depresión, aislamiento, agresividad, estrés, temor social, timidez, sensación de incapacidad, entre otras afectaciones que pueden surgir a partir de procesos de estigmatización.

This research arises from the question of social stigmatization in the school field generated by a psychological diagnosis. The educational context is the scene of various dynamics that influence the process of student development, there are stages of transition such as the transition from elementary to high school, in a period of life in which the adolescent is in full construction of his identity. It is a stage of adaptation to the environment, this being a period of vulnerability that can be significantly affected when the students also carries with them a psychological diagnosis that can generate social stigma. This research was conducted on the basis of a theoretical trace and a unique case study, in which an interview was conducted with a student with an established diagnosis, another to its mother, a teacher and two psychologists of the educational institution. It was possible to identify the categories of diagnosis, school subject and identity in relation to stigmatization, and from rigorous work of tracking and analysis, it was concluded that having a psychological diagnosis is highly related to social stigma and labeling by other people, which has important implications for the psychosocial development of the stigmatized person, generating negative repercussions such as low self-esteem, insecurity, depression, isolation, aggressiveness, stress, social fear, shyness, feeling incapacity, among other impacts that can arise from stigmatization processes.

Propiedades psicométricas del Cuestionario de ansiedad social para adultos (CASO) en Perú / Psychometric properties of the Social Anxiety Questionnaire for Adults (SAQ) in Peru

Resumen La investigación sobre la evaluación de la ansiedad social en Iberoamérica es escasa. En los últimos años se ha informado sobre las características psicométricas del "Cuestionario de ansiedad social para adultos" (CASO) en distintos países iberoamericanos, excepto Perú. El objetivo de este estudio fue analizar las pruebas de validez basadas en el constructo, las pruebas de validez basadas en la relación con otras variables de tipo convergente y la fiabilidad del CASO, utilizando una muestra no clínica de 3064 peruanos. El análisis factorial confirmatorio comprobó que el modelo de cinco factores relacionados se ajustaba mejor a los datos que el modelo jerárquico y se halló que el modelo unifactorial no tenía un buen ajuste. Las correlaciones entre los factores del CASO (de .608 a .709) indicaron que cada uno de ellos evalúa aspectos específicos del constructo y aportan, a su vez, a la medición global del mismo. Los coeficientes de fiabilidad fueron de aceptables a muy buenos (.78( (( .85, .75( (( .83). La alta correlación (r= .69) con la subescala de Ansiedad de la "Escala de ansiedad social de Liebowitz, versión de autoinforme" (LSAS-SR), apoya su relación con la variable convergente. Estas adecuadas características psicométricas del CASO respaldan su utilización con población peruana.

Abstract Research on the assessment of social anxiety in Ibero-America is scarce. In recent years, the psychometric characteristics of the Social Anxiety Questionnaire for adults (SAQ) have been reported in different Ibero-American countries except Peru. The aim of this study was to analyze the construct and the convergent validity, and the reliability of the SAQ, using a non-clinical sample of 3064 Peruvians. The confirmatory factorial analysis showed that the model of five-related factors was better adjusted to the data than the hierarchical model, and that the unifactorial model did not have a good fit. The correlations between their factors (from .608 to .709) indicate that each of them evaluates specific aspects of the construct and also contribute to the overall measurement of it. The reliability coefficients were from acceptable to very good (.78( (( .85, .75( (( .83). The high correlation (r= .69) with the Anxiety subscale of the "Liebowitz Social Anxiety Scale-Self-Report version" (LSAS-SR) supports its convergent validity. These appropriate psychometric characteristics of the questionnaire support its use with the Peruvian population.

The latent structure of the Young Schema Questionnaire-Short Form

Objective: The current study aimed to examine the latent structure of a web-based, Brazilian Portuguese version of the Young Schema Questionnaire-Short Form (YSQ-SF). Method: The sample consisted of 15,557 adult participants - 4,702 men and 10,855 women - with age ranging from 18 to 60 years. Confirmatory factor analysis was used to test the a priori conceptual 15-factor model presumed to underlie the YSQ-SF item set. Results: Most items displayed high levels of reliability (factor loadings greater than 0.7) and low liability to random measurement error (residual variances below 0.02), indicating that the a priori YSQ-SF factor structure is adequate. Discussion: These findings offer empirical evidence supporting YSQ-SF construct validity and, consequently, its application in adults.

Psychometric properties of two adolescent depression scales in a colombian community sample: ADRS and RCADS -major depression / Propiedades psicométricas de dos escalas de depresión para adolescentes en una muestra comunitaria colombiana: ADRS y RCADS -depresión mayor

Abstract Depression can occur at all ages; however, when it begins early in life, prognosis is less favorable. Early identification and treatment provision need valid and reliable tools to assess depression in children and adolescents. The present study aimed at analyzing, in a Colombian community sample, the psychometric properties of two brief depression scales, using Classical Test Theory methods: The Adolescent Depression Rating Scale (ADRS) self-report version and the Revised Child Anxiety and Depression Scale (RCADS) - Major Depression Subscale. Analyses of both scales showed most item-scale and item-item correlations to be moderate and significant. Internal consistency was significant and adequate for both, ADRS (.67) and RCADS- Major Depression (.71). For ADRS, a two-factor solution explained 37.39% of variance while a one-single factor explained 25.99%. For RCADS-Major Depression, a two-factor solution explained 41.81% of variance while a one-single factor explained 29.14%. Construct validity was satisfactory, as both scales showed moderate and significant correlations with the convergent (RCADS-Generalized Anxiety) and the discriminant (KADS-11) criteria; yet, correlations with the former were stronger. Results provide further evidence in favor of the ADRS and the RCADS-Major Depression as effective tools to assess depressive symptoms in children and adolescents.

Resumen La depresión puede presentarse a cualquier edad; sin embargo, cuando ocurre en etapas tempranas de la vida el pronóstico es menos favorable. La identificación y el tratamiento tempranos necesitan herramientas válidas y confiables para evaluar la depresión en niños y adolescentes. El presente estudio analizó, en una muestra comunitaria colombiana, las propiedades psicométricas de dos escalas breves de depresión, utilizando métodos de la Teoría Clásica de los Test: Escala de Valoración de Depresión Adolescente (ADRS) versión de auto-reporte y la Escala de Ansiedad y Depresión Infantil Revisada (RCADS)- Subescala de Depresión Mayor. El análisis de las dos escalas mostró correlaciones ítem-ítem e ítemescala, moderadas y significativas. La consistencia interna fue significativa y adecuada para ambas escalas, ADRS (0.67) y RCADS-Depresión Mayor (0.71). Para ADRS, dos factores explicaron 37.39% de la varianza, mientras que la solución de un solo factor explicó 25.99% de la varianza. Para RCADS-Depresión Mayor, dos factores explicaron el 41.81% de varianza y un factor único explicó 29.14%. La validez de constructo fue satisfactoria, ambas escalas mostraron correlaciones moderadas y significativas con el criterio convergente (KADS-11) y el criterio discriminante (RCADS-Ansiedad Generalizada); aunque más fuertes en el primer caso. Los resultados evidencian que ADRS y RCADS-Depresión Mayor son herramientas efectivas para la valoración de síntomas depresivos en niños y adolescentes.

Prevención de la depresión posparto en madres adolescentes atendidas en el Hospital General Ambato; 2017 / Prevention of postpartum depression in adolescent mothers treated at the Ambato General Hospital; 2017

Introducción: La depresión posparto es un trastorno depresivo que puede empezar en cualquier momento después del parto que puede durar de semanas a meses, se acompaña de síntomas como: fatiga, pérdida de energía, incomodidad, problemas para conciliar el sueño, entre otros. Objetivo: Diseñar una estrategia que contribuya a la prevención de la depresión posparto en madres adolescentes atendidas en el servicio de Gineco-obstetricia del Hospital General Ambato. Métodos: La investigación responde a una modalidad cuantitativa; no experimental con desarrollo de diagnóstico transversal, descriptivo con una muestra de 50 madres adolescentes. Resultados: Las madres adolescentes más propensas a sufrir una depresión posparto están comprendidas entre los 14-16 años en un 58% y son solteras en un 72%, la relación que mantienen con la familia es buena en un 38%, la violencia física y psicológica intrafamiliar si existe rara vez demostrándose en un 48%, existe un desconocimiento sobre la depresión posparto manifestándose en un 98%. Conclusiones: Los factores predisponentes para desencadenar en una depresión posparto son las madres adolescentes solteras por la falta de apoyo de la pareja, la relación afectiva y de dependencia que tienen con la familia, la falta de apoyo proporcionado por la familia durante el embarazo y en la crianza del bebé y lo más relevante el desconocimiento sobre la depresión posparto por ende no estarían en capacidad de reconocer la sintomatología

Introduction: Postpartum depression is a depressive disorder that can start at any time after delivery that can last from weeks to months, is accompanied by symptoms such as fatigue, loss of energy, discomfort, trouble falling asleep, among others. Objective: To design a strategy that contributes to the prevention of postpartum depression in adolescent mothers assisted in the Obstetrics and Gynecology service of the Ambato General Hospital. Methods: The research responds to a quantitative modality; non-experimental with development of cross-sectional diagnosis, descriptive with a sample of 50 adolescent mothers. Results: Adolescent mothers more prone to suffer postpartum depression are between 14-16 years old in 58% and are single in 72%, their relationship with the family is good in 38%, physical violence and intrafamilial psychological if it is rarely demonstrated by 48%, there is a lack of knowledge about postpartum depression manifested in 98%. Conclusions: The predisposing factors to trigger postpartum depression are single teenage mothers due to the lack of support from the couple, the affective and dependent relationship they have with the family, the lack of support provided by the family during pregnancy and in the upbringing of the baby and most relevant the ignorance about the postpartum depression therefore they would not be able to recognize the symptomatology

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

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

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

Effectiveness and Safety of Bupropion in Children and Adolescents with Depressive Disorders: A Retrospective Chart Review

OBJECTIVE: This study aimed to investigate the effectiveness and safety of bupropion extended-release for the treatment of depressive disorder in children and adolescents. METHODS: This was a 12-week, retrospective chart review of bupropion, which included 127 youth (age, 15.3 ± 2.3 years; 66 boys) with depressive disorders (105 with major depressive disorder, 14 with dysthymia, 11 with adjustment disorder with depressed mood, and seven with depressive disorder not otherwise specified). Illness severity at baseline and at the 4th, 8th, and 12th weeks was retrospectively scored using the Clinical Global Impressions-Depression-Severity (CGI-Depression-S) and/or Clinical Global Impressions-Depression-Improvement (CGI-Depression-I). RESULTS: The mean dose of bupropion was 180.0 ± 52.6 (range, 75–300) mg/day and the mean duration 33.9 ± 53.1 (range, 7–295) weeks. The CGI-Depression-S scores were significantly decreased over 12 weeks (F = 132.125, p < 0.001, partial η² = 0.508). Fifty-eight subjects (45.7%) were determined to be responders at 12 weeks (defined by a CGI-Depression-I score ≤ 2). Forty-six patients (36.2%) discontinued bupropion before the 12 weeks (19 due to adverse events, 15 due to poor effectiveness, three due to referral to other clinics, and nine due to follow-up loss for unknown reasons). Overall, bupropion was well tolerated. The most common adverse event was irritability (n = 12, 9.4%), which resolved spontaneously in eight subjects or after drug discontinuation in four subjects. CONCLUSION: Our results provide preliminary evidence of the effectiveness and safety of bupropion in children and adolescents with depressive episodes. Large, prospective, placebo-controlled studies are needed to confirm these findings.

Posttraumatic Embitterment Disorder in Patients with Chronic Kidney Disease

OBJECTIVE: Posttraumatic embitterment disorder (PTED), a subgroup of an adjustment disorder, is a feeling with anger and helplessness. Hemodialysis may be a trigger event leading to PTED. We investigated the prevalence of PTED in patients with each categorized stages of chronic kidney disease (CKD) and the association between PTED and depression and functional impairment. METHODS: Patients were categorized into three groups according to the stages of CKD (stage I–II, III–IV, and V). CKD (I–II) group was defined as estimated glomerular filtration rate (eGFR) >60 ml/min/1.73 m², CKD (III–IV) group as eGFR <60 ml/min/1.73 m², and CKD (V) group as CKD stage V including patients ongoing hemodialysis. Patients were assessed for the prevalence of PTED, depression, and decreased quality of life by using the scale of PTED, Patient Health Questionnaire-9 (PHQ-9), and EuroQol Five Dimensional Questionnaires, Visual Analogue Scale (EQ-5D-VAS), respectively. RESULTS: A total of 445 patients were analyzed. The number of patients in CKD (I–II) was 166, CKD (III–IV) was 172, and CKD (V) was 107. Multivariate analysis by binomial logistic regression demonstrated that CKD (V) was significantly associated with the prevalence of PTED (odds ratio, 4.13; 95% confidence interval, 1.56–15.6; p=0.006) after adjustment for age, gender, and diabetes mellitus. Also, a significant correlation existed between PTED and EQ-5D-VAS in all stages, but the correlation was nonsignificant between PTED and PHQ-9 score in group CKD (V). CONCLUSION: The findings suggest that PTED is underdiagnosed in CKD patients. Acknowledgment and diagnosis of PTED in CKD patients may lead to a better quality of life.

Psychiatric Symptoms and Clinical Diagnosis in High School Students Exposed to the Sewol Ferry Disaster

BACKGROUND: Two hundred and fifty 11th grade students and teachers from Danwon High School drowned, during a school trip, in the Sewol Ferry Disaster. The goal of this study was to investigate the experiences of the psychiatrists who volunteered and provided psychiatric services to the students at Danwon High School. METHODS: From the second day to the 138th day after the disaster, pro bono psychiatrists provided post-disaster interventions to the 10th and 12th-grade Danwon High School students who did not attend the trip. Officially, 167 psychiatrists conducted outreach in approximately 550 encounters. The study questionnaires were distributed retrospectively to psychiatric volunteers who conducted outreach at Danwon High School. We surveyed the pro bono psychiatrists about their experiences, including the students' chief complaints, psychiatric problems, clinical diagnoses, and psychiatrists' treatment recommendations. RESULTS: We reached 72 (43.1%) of the 167 volunteers, and they reported on 212 (38.6%) of the 550 encounters. The common chief complaints were mental health problems, companion problems, and family problems. The most frequent psychiatric symptoms were anxiety (76.89%), depressive mood (51.42%), and concentration difficulty (50.94%). The most frequent clinical diagnoses of the students were normal reaction (41.04%), acute stress disorder (24.53%), adjustment disorder (17.92%), anxiety disorders (9.43%), and posttraumatic stress disorder (6.60%). More than half of the students needed “additional counseling/therapy” (41.04%) or “referral to psychiatric treatment” (14.15%). CONCLUSION: During the acute aftermath of the Sewol Ferry Disaster, volunteer psychiatrists were able to provide services. These services included psychiatric assessments, crisis counseling, psychological first aid, and referrals for ongoing care. More than half of the students were perceived to have a psychiatric diagnosis, and a substantial proportion of students needed further treatment. Future research should focus on the short- and long-term effects of psychiatric interventions and the characterization of post-disaster mental health needs and service provision patterns.

Transgenerational Transmission of Trauma: Psychiatric Evaluation of Offspring of Former “Comfort Women,” Survivors of the Japanese Military Sexual Slavery during World War II

“Comfort women” are survivors of sexual slavery by the Imperial Japanese Army during World War II, who endured extensive trauma including massive rape and physical torture. While previous studies have been focused on the trauma of the survivors themselves, the effects of the trauma on the offspring has never been evaluated before. In this article, we reviewed the first study on the offspring of former “comfort women” and aimed to detect the evidence of transgenerational transmission of trauma. In-depth psychiatric interviews and the Structured Clinical Interview for DSM-5 Axis I Disorders were conducted with six offspring of former “comfort women.” Among the six participants, five suffered from at least one psychiatric disorder including major depressive disorder, panic disorder, posttraumatic stress disorder, adjustment disorder, insomnia disorder, somatic symptom disorder, and alcohol use disorder. Participants showed similar shame and hyperarousal symptoms as their mothers regarding stimuli related to the “comfort woman” issue. Increased irritability, problems with aggression control, negative worldview, and low self-esteem were evident in the children of mothers with posttraumatic stress disorder. Finding evidence of transgenerational transmission of trauma in offspring of “comfort women” is important. Future studies should include more samples and adopt a more objective method.