RESUMEN
Introduction: In Colombia, children are frequently exposed to traumatic events; however, there are no data regarding the impact on depression, anxiety and somatic correlates of such exposure in children living in rural communities. Objective: To investigate the somatic complaints and symptoms of depression and anxiety among children exposed to traumatic events in a rural community of Colombia. Methods: Design: Cross-Sectional study. Participants: Two hundred and ninety-three Colombian children aged eight to 18 years. Main Outcome Measures: Standardized measures were administered to assess children's depression, anxiety, physical symptoms and exposure to traumatic events. Depression: CDI (Children's Depression Inventory); anxiety: SCARED (The Screen for Child Anxiety Related Emotional Disorders); somatic complaints: CBCL (Child Behavior Checklist, Somatic Complaints scale) and reporting traumatic events during the K-SADS-PL (Diagnostic Interview for Children and Adolescents). Results: Ninety-one of the 293 children (31.1%) reported somatic complaints. The most common somatic complaint was in the gastrointestinal category (35/91). One hundred and seventy eight children (60.5%) had observed traumatic events, including homicides during the last month. Two hundred five (69.9%) of the children showed depressive symptom profiles above established norms, and 239 (81.6%) exhibited anxiety symptoms according to their own reports. The correlation between depression and traumatic events, anxiety and somatic complaints, and between anxiety and depression were statistically significant (p<0.005). Conclusions: As the first study of its kind in children living in rural communities in Colombia, it demonstrates a clear impact of traumatic events on mental health. Information that somatic complaints are commonly an expression of underlying depression and anxiety may facilitate the treatment and thereby help avoid unnecessary medical workups and sequelae from traumatized children. It is important for physicians to probe for "hidden" symptoms in traumatized children.
Introducción: En Colombia, los niños están expuestos con frecuencia a eventos traumáticos, sin embargo, no hay datos sobre el impacto de la depresión, la ansiedad y la correlación somática de dicha exposición en niños que viven en comunidades rurales. Objetivo: investigar las alteraciones somáticas, síntomas de depresión y ansiedad en los niños expuestos a eventos traumáticos en una comunidad rural de Colombia. Metodología: Diseño: Estudio transversal; Participantes: Doscientos noventa y tres niños colombianos de ocho a 18 años. Principales medidas de resultado: se aplicaron medidas estandarizadas para evaluar la depresión infantil, ansiedad, síntomas físicos y la exposición a eventos traumáticos. Depresión:CDI (Children's Depression Inventory)). Ansiedad: SCARED (The Screen for Child Anxiety Related Emotional Disorders), Enfermedades somáticas: CBCL (Child Behavior Checklist, Somatic Complaints scale) e informar los eventos traumáticos durante el K -SADS -PL (Diagnostic Interview for Children and Adolescents). Resultados: Noventa y uno de los 293 niños ( 31,1 % ) informaron de síntomas somáticos. La queja somática más común estuvo en la categoría gastrointestinal (35/ 91). Ciento setenta y ocho niños ( 60,5 % ) habían observado los acontecimientos traumáticos, incluyendo homicidios durante el último mes. Doscientos cinco ( 69,9 % ) de los niños mostraron perfiles de síntomas depresivos por encima de las normas establecidas, y 239 ( 81,6 % ) presentaban síntomas de ansiedad según sus propios informes. La correlación entre la depresión y los eventos traumáticos, la ansiedad y quejas somáticas, y entre la ansiedad y la depresión fueron estadísticamente significativas ( p < 0,005 ). Conclusiones: como el primer estudio de su tipo en los niños que viven en comunidades rurales de Colombia , demuestra un claro impacto de eventos traumáticos en la salud mental. La afirmación que las quejas somáticas son comúnmente una expresión de la depresión y la ansiedad subyacente puede facilitar el tratamiento y de ese modo ayudar a evitar abordajes médicos innecesarios y secuelas en los niños traumatizados . Es importante para los médicos explorar los síntomas "ocultos" en los niños traumatizados.
RESUMEN
O milnaciprano é um novo antidepressivo que alega ter menos efeitos colaterais do que os antidepressivos clássicos. Relatamos um caso no qual a paciente tentou suicídio por overdose. Durante a primeira hora após ingestão desse medicamento, a paciente apresentou náusea, vômitos proeminentes, diaforese e perda de consciência. A paciente recuperou-se satisfatoriamente da overdose de milnaciprano e clonazepam. Demonstramos que o milnaciprano é um medicamento seguro em casos de overdose. Atenção especial e pesquisas futuras sobre esse fenômeno são altamente indicadas em função do uso comum desse medicamento.
Milnacipran is a new antidepressant, which is claimed to have fewer side effects than classic antidepressives. We report one case where patient attempted suicide by overdose. During the first hour following the ingestion of this drug, the patient presented nausea, notable emesis, diaphoresis and loss of consciousness. The patient's recovery from the overdose of milnacipran and clonazepam was satisfactory. We can show that milnacipran is a safe medication in overdose cases. Special awareness and future research of this phenomenon is highly indicated because of the common use of this drug.