Ansiedad frente a exámenes, un tipo de ansiedad fóbica que se presenta en el contexto académico / Test anxiety, a type of phobic anxiety that occurs in the academic context

Experimentar ansiedad frente a exámenes desencadena una respuesta emocional acompañada de cambios fisiológicos que el estudiante siente ante una situación percibida como amenazante, específicamente ante una evaluación, examen escrito u oral; actualmente, se la cataloga dentro de las fobias específicas. El individuo que busca evitar o eludir dicho escenario cae en la conducta de procrastinación. Esto afecta su rendimiento académico y acarrea consecuencias graves de salud mental, el estudiante comienza a percibirse afectado en su autovalia, autoestima y en su ambiente social, que muchas veces lo lleva a contraer trastorno depresivo e ideación suicida. El presente artículo es un estudio de revisión bibliográfica y su objetivo fue describir la experiencia de la. ansiedad frente a exámenes como fobia específica situacional, las consecuencias de dicho padecimiento, su comorbilidad con otros trastornos psicológicos y los tratamientos disponibles. Fueron analizados y comparados unos 26 artículos científicos, basados en ensayos controlados de manera aleatoria, otros son estudios controlados de caso único, publicados en importantes revistas electrónicas de impacto. La búsqueda se realizó utilizando las palabras clave. Como conclusión, se destacó la importancia del conocimiento de esta patología, a fin de realizar un diagnóstico precoz y prevención en psicoterapia, evitando así un mayor deterioro en la salud mental de los estudiantes. No obstante, es necesaria la realización de más investigación controlada al respecto.

Experiencing test anxiety triggers an emotional response accompanied by physiological changes that the student feels in a situation perceived as threatening, specifically in the face of an evaluation, written or oral exam; Currently, it is classified as a specific phobia. The individual who seeks to avoid or avoid this scenario falls into procrastination behavior. This affects their academic performance and has serious mental health consequences. The student begins to feel affected in his or her self-worth, self-esteem, and social environment, which often leads him or her to contract a depressive disorder and suicidal ideation. This article is a bibliographic review study regarding experiencing test anxiety as a situational specific phobia, the consequences of said condition, its comorbidity with other psychological disorders and the available treatments. Some 26 scientific articles were analyzed and compared, based on randomized controlled trials, others are controlled single case studies, published in important impact electronic journals. The search was carried out using keywords. In conclusion, the importance of knowledge of this pathology was highlighted, in order to make an early diagnosis and prevention in psychotherapy, thus avoiding further deterioration in the mental health of students. However, more controlled research is needed in this regard.

Prevalencia y correlatos de ideación suicida pasiva y activa en ingresantes de posgrado / Prevalence and correlates of passive and active suicidal ideation among students entering graduate courses / Prevalência e correlatos de ideação suicida passiva e ativa em ingressantes da pós-graduação

Objetivo: identificar la prevalencia y los factores asociados a la ideación suicida pasiva y activa a lo largo de la vida en estudiantes ingresantes de posgrado. Método: estudio analítico y de diseño transversal, con una muestra compuesta por 321 estudiantes ingresantes de posgrado. Se realizó análisis estadístico descriptivo e inferencial múltiple. Resultados: los análisis multivariados indican que la ideación suicida pasiva y activa tuvieron una prevalencia mayor y similar en los estudiantes de orientación sexual minoritaria, del sexo femenino, que realizaban actividad física diaria ≤ 30 minutos/día y sufrieron victimización por violencia psicológica en los últimos 12 meses. Los factores abuso de alcohol, las exigencias del posgrado stricto sensu no afectaron las relaciones familiares y baja autoestima se asociaron solo con la ideación suicida pasiva. A su vez, el consumo de marihuana en los últimos 30 días, no tener una buena relación interpersonal con sus pares académicos, ejercer la actividad profesional junto con las exigencias del posgrado se asociaron únicamente con ideación suicida activa. Conclusión: se identificó una alta prevalencia de ideación suicida pasiva y activa a lo largo de la vida en los estudiantes ingresantes de posgrado y se comprobó que hubo similitudes y diferencias entre algunos de los factores asociados a ambos resultados.

Objective: to identify the prevalence and factors associated with passive and active suicidal ideation throughout life among students entering graduate courses. Method: an analytical and cross-sectional study with a sample comprised of 321 students entering graduate courses. Multiple descriptive and inferential statistical analyses were performed. Results: the multivariate analyses indicated that passive and active suicidal ideation were similarly more prevalent among female students belonging to minority sexual orientations who engaged in daily physical activity ≤ 30 minutes/day and were victims of psychological violence in the past 12 months. Alcohol abuse, family relationships not impaired due to the demands imposed by stricto sensu graduate studies and low self-esteem were only associated with passive suicidal ideation. In turn, recent marijuana use in the last 30 days, poor interpersonal relationships with academic peers, and engagement in professional activities concomitantly with the demands imposed by graduate studies were only associated with active suicidal ideation. Conclusion: high prevalence of lifetime passive and active suicidal ideation was identified among graduate students, and similarities and differences were verified between some associated factors for both outcomes.

Objetivo: identificar a prevalência e fatores associados à ideação suicida passiva e ativa ao longo da vida em estudantes ingressantes na pós-graduação. Método: estudo analítico e de delineamento transversal, amostra composta por 321 estudantes ingressantes da pós-graduação. Realizou-se análise estatística descritiva e inferencial múltipla. Resultados: análises multivariadas apontaram que ideação suicida passiva e ativa foram similarmente mais prevalentes entre estudantes de orientações sexuais minoritárias, do sexo feminino, que realizavam atividade física diária ≤ 30 minutos/dia e sofreram vitimização por violência psicológica nos últimos 12 meses. O abuso de álcool, o não prejuízo no relacionamento familiar por demandas da pós-graduação stricto sensu e a baixa autoestima foram associadas unicamente com ideação suicida passiva. Por sua vez, o consumo de maconha ocorrido nos últimos 30 dias, a falta de um relacionamento interpessoal satisfatório com seus pares acadêmicos e a prática da atividade profissional em concomitância com as demandas da pósgraduação foram associadas apenas com ideação suicida ativa. Conclusão: identificou-se alta prevalência de ideação suicida passiva e ativa ao longo da vida entre estudantes ingressantes na pós-graduação e verificou-se a ocorrência de similitudes e diferenças entre alguns fatores associados para ambos os desfechos.

A Escola Sob Ataque e o Lento Cancelamento do Futuro / The School Under Attack and the Slow Cancellation of the Future / La Escuela Bajo Ataque y la Lenta Cancelación del Futuro

A realidade social, política e educacional do Brasil, nos últimos anos, vem cobrando novos posicionamentos do campo que articula a Psicanálise e a Educação no país. Com o artigo, buscamos modos da Psicanálise, como uma teoria crítica, em diálogo com o campo da educação e da política, contribuir com um melhor entendimento dos sintomas sociais que se apresentam nas questões educacionais e, em especial, na onda de violência que atualmente assola as instituições escolares. Entendemos que os recentes ataques às escolas têm que ser vistos no contexto de vários outros ataques, desde a ausência histórica de investimentos em educação no país, até ao espectro de morte que ronda o cotidiano escolar, com as altas taxas de homicídios e suicídios de adolescentes, expressões e consequências da necropolítica e do Estado suicidário que se instala na sociedade brasileira. Para discutir aspectos educacionais é ainda necessário articular questões das ciências, da natureza, da economia e da política. À guisa de conclusão, o escrito provoca a necessidade de que se possa fazer, aos jovens, a transmissão pelo desejo de imaginar outros mundos e sonhar outros sonhos.

The social, political and educational reality in Brazil, in recent years, has demanded new positions from the field that articulates Psychoanalysis and Education in the country. This article seeks ways for Psychoanalysis, as a critical theory, in dialogue with the field of education and politics, to contribute to a better understanding of the social symptoms that appear in educational issues and, in particular, in the wave of violence that currently plagues educational institutions. We understand that the recent attacks on schools have to be seen in the context of several other attacks, from the historical lack of investment in education in the country, to the spectre of death that surrounds everyday school life, with the high rates of homicides and suicides in adolescents - expressions and consequences of necropolitics and the suicidal state that is installed in Brazilian society. When discussing educational aspects, we necessarily need to articulate issues of science, nature, economics and politics. By way of conclusion, this paper provokes the need to transmit to young people the desire to imagine other worlds and dream other dreams.

La realidad social, política y educativa en Brasil, en los últimos años, ha demandado nuevos posicionamientos del campo que articula el Psicoanálisis y la Educación en el país. De esta manera, el artículo busca caminos para que el Psicoanálisis, como teoría crítica, en diálogo con el campo de la educación y la política, contribuya a una mejor comprensión de los síntomas sociales que aparecen en los temas educativos y, en particular, en la ola de violencia que azota actualmente a las instituciones educativas. Entendemos que los recientes ataques a escuelas tienen que ser vistos en el contexto de varios otros ataques, desde la falta histórica de inversión en educación en el país, hasta el espectro de muerte que rodea la cotidianidad escolar, con los altos índices de homicidios y suicidios en adolescentes, expresiones y consecuencias de la necropolítica y del estado suicida que se instala en la sociedad brasileña. Es decir, cuando se habla de aspectos educativos, necesariamente necesitamos articular temas de ciencia, naturaleza, economía y política. A modo de conclusión, el escrito provoca la necesidad de transmitir a los jóvenes el deseo de imaginar otros mundos y soñar otros sueños.

Exposición a la violencia e ideación suicida en estudiantes universitarios de Santa Marta, Colombia

Introducción: La exposición a la violencia afecta la salud mental. Sin embargo, existen pocos estudios sobre este fenómeno en estudiantes universitarios. Objetivo: Establecer la asociación entre la exposición a la violencia e ideación suicida en universitarios de Santa Marta, Colombia. Metodología: Se realizó un estudio cuantitativo, analítico y transversal. Participaron 1647 estudiantes entre 16 y 24 años (M=20,58, DT=1,715), quienes completaron la Escala de Exposición a la Violencia (α = 0,87) y la Escala de Ideación Suicida de Roberts (α =0,74). Resultados: El modelo de regresión logística ajustado indicó que la exposición directa a la violencia en el colegio (OR=2,02; IC95 %=1,28-3,16) y casa (OR=1,53; IC95 %=1,02-2,29), e indirecta en colegio (OR=1,34; IC95 %= 11,06-1,70) y casa (OR=1,91; IC95 %=1,27-2,88), incrementan la ideación suicida. Conclusiones: La exposición a la violencia en el colegio y en la casa, de forma directa e indirecta, son factores de riesgo para la ideación suicida en estudiantes universitarios.

Introduction: Exposure to violence affects mental health; however, there are few studies on this phenomenon in university students. Objective: To establish the association between exposure to violence and suicidal ideation in university students from Santa Marta, Colombia. Methodology: A quantitative, analytical, and cross-sectional study was carried out involving 1,647 students between 16 and 24 years old (M=20.58, SD=1.715), who completed the violence exposure Scale (α =0.87) and the Roberts suicidal ideation scale (α =0.74). Results: The adjusted logistic regression model indicated that direct exposure to violence at school (OR=2.02; 95% CI=1.28-3.16) and home (OR=1.53; 95% CI=1.02 -2.29), and indirect exposure at school (OR=1.34; CI95%= 1.06-1.70) and home (OR=1.91; CI95%=1.27-2.88), increased suicidal ideation. Conclusion: Direct and indirect exposure to violence at school and at home are risk factors for suicidal ideation in university students.

Autolesión no suicida en población general: frecuencia y factores asociados en Paraguay

Introducción: La investigación sobre la autolesión no suicida permite aumentar la conciencia sobre este fenómeno, posibilita su detección temprana y la implementación de estrategias más eficaces en prevención y tratamiento. Esto conlleva a una reducción del sufrimiento individual, los costos económicos y el impacto en la sociedad en su totalidad. Objetivo: Determinar la frecuencia y factores asociados a autolesión no suicida en una muestra de población adulta de Paraguay. Metodología: Estudio descriptivo de asociación cruzada, de corte transversal y prospectivo. Una encuesta en línea fue difundida a través de redes sociales y aplicaciones de mensajería. Esta incluía preguntas sobre datos sociodemográficos y clínicos. La presencia de autolesiones se determinó a través de la versión en español de la escala Self-Harm Questionnaire. Se utilizó estadística descriptiva para todas las variables. Para buscar asociaciones se utilizó la prueba chi cuadrado. Resultados: Participaron 241 personas (media de edad=32±12 años, 74,7% mujeres). Se encontró una frecuencia de autolesiones de 24,5% (n=59). De estos, el 91,5% había tenido ideación suicida al menos una vez. Se encontró asociación entre el nivel de ingresos y la frecuencia de autolesiones (χ

Introduction: Research on non-suicidal self-injury raises awareness of this phenomenon, enabling the early detection and implementation of more effective strategies in prevention and treatment. This leads to a reduction in individual suffering, economic costs, and impact on society. Objective: To determine the frequency and associated factors of non-suicidal self-injury in a sample of the adult population of Paraguay. Methodology: This was a descriptive, cross-sectional, and prospective study. An online survey was disseminated through social networks and messaging applications. The survey included questions on sociodemographic and clinical data. The presence of self-injury was determined by using the Spanish version of the Self-Harm Questionnaire. Descriptive statistics were used for all the variables. The chi-square test was used to examine associations. Results: There were 241 participants (mean age=32±12 years, 74.7%female). A non-suicidal self-injury frequency of 24.5% (n=59) was observed. Of these, 91.5% reported suicidal ideation at least once. An association was found between income level and the frequency of non-suicidal self-injury (χ

Ideação e comportamentos suicidas em mulheres privadas de liberdade em uma unidade prisional do estado do Paraná / Suicidal ideation and behavior in women deprived of liberty in a prison unit in the state of Paraná

Resumo: A ideação e comportamentos suicidas são considerados um problema de saúde pública. Mulheres privadas de liberdade podem apresentar maior vulnerabilidade para esses comportamentos, considerando as condições no ambiente prisional, a perda de vínculos familiares e os históricos de comorbidades mentais e físicas. Trata-se de um estudo quantitativo transversal, com o objetivo geral de analisar a ideação e os comportamentos suicidas em mulheres privadas de liberdade em uma unidade prisional do Estado do Paraná. A amostra foi por conveniência e constituída de 30 mulheres privadas de liberdade. Os dados foram coletados de maio a agosto de 2022 com aplicação do instrumento Columbia-Suicide Severity Rating Scale e de um instrumento elaborado pelos autores. Os resultados foram apresentados de maneira descritiva e inferencial. Da amostra de 30 mulheres, 15 (50,0%) eram da faixa etária de 30 a 49 anos; 15 (50,0%) declararam-se pardas; 18 (60,0%) eram solteiras; 17 (56,7%) estavam desempregadas antes da prisão; 14 (46,7%) apresentavam condição de saúde mental; 21 (70,0%) eram tabagistas; 22 (73,3%) faziam uso de álcool; e 17 (56,7%) fizeram uso de SPA. O motivo da privação de liberdade foi homicídio para 15 (50,0%) participantes. Da amostra, 20 (66,7%) foram vítimas de violência física alguma vez na vida; 17 (56,7%) de violência psicológica; e 14 (46,7%), de violência sexual. Quanto à ideação, 16 (53,3%) mulheres já haviam desejado estar mortas; 19 (63,3%) haviam tido pensamentos suicidas ativos não específicos; 15 (50,0%) haviam tido ideação suicida ativa com algum método (sem plano) sem intenção de agir; 15 (50%) haviam tido ideação suicida ativa com alguma intenção de agir; e 14 (46,7%) havia tido ideação suicida ativa com plano específico e intenção. Durante a privação de liberdade, 12 (40%) apresentaram pensamentos suicidas. Empreenderam comportamentos suicidas durante a vida 16 (53,3%) mulheres; 14 (46,7%) tiveram tentativa efetiva; 6 (20,0%), comportamento autolesivo sem intenção suicida; 8 (26,7%) tiveram tentativa interrompida; 7 (23,3%) tiveram tentativa abortada; 10 (33,3%) realizaram atos ou comportamentos preparatórios; 4 (13,3%) empreenderam tentativas de suicídio durante a privação de liberdade, das quais 3 (10,0%) empreenderam pela primeira vez durante a privação de liberdade. Na análise inferencial, as principais variáveis associadas à ideação e aos comportamentos suicidas foram: ideação suicida antes da privação de liberdade, ideação suicida durante a privação de liberdade, tratamento para condição de saúde mental, vítima de violência sexual, tentativa de suicídio e ideação suicida ativa com algum método (sem plano) sem intenção de agir. Considerando os resultados desta pesquisa e o que é previsto pela equipe de enfermagem no sistema prisional, conclui-se pela importância de avaliar a ideação e os comportamentos suicidas em mulheres privadas de liberdade desde a admissão, na permanência da privação, bem como nos aspectos relacionados à ocorrência de tais comportamentos visando à oferta de cuidados de enfermagem na prevenção, no evento e na reabilitação.

Abstract: Suicidal ideation and behaviors are considered a public health problem. Women deprived of their liberty may be more vulnerable to these behaviors, considering the conditions in the prison environment, the loss of family ties and histories of mental and physical comorbidities. This is a cross-sectional quantitative study with the general objective of analyzing suicidal ideation and behaviors in women deprived of their liberty in a prison unit located in the State of Paraná. A convenience sample was used, and it was made up of 30 women deprived of their liberty. Data were collected from May to August 2022 using the Columbia-Suicide Severity Rating Scale instrument and another instrument developed by the authors. The results were presented in a descriptive and inferential manner. Of the sample made up of 30 women, 15 (50.0%) were aged between 30 and 49; 15 (50.0%) self-declared as mixed race; 18 (60.0%) were single; 17 (56.7%) were unemployed before the arrest; 14 (46.7%) experienced mental health disorder; 21 (70.0%) were smokers; 22 (73.3%) were alcohol users; and 17 (56.7%) had used some PAS. The deprivation of liberty was caused by homicide for 15 (50.0%) participants. Of the sample, 20 (66.7%) were victims of physical violence at some point in their lives; 17 (56.7%) were victims of psychological violence; and 14 (46.7%) of sexual violence. As for suicidal ideation, 16 (53.3%) women had already wished they were dead; 19 (63.3%) had already had non-specific active suicidal thoughts; 15 (50.0%) had already had active suicidal ideation with a method (not plan) without intent to act; 15 (50%) had already had active suicidal ideation with some intent to act; and 14 (46.7%) had already had active suicidal ideation with a specific plan and intent. During their period of deprivation of liberty, 12 (40%) had suicidal thoughts. 16 (53.3%) women engaged in suicidal behavior during their lifetime; 14 (46.7%) made an actual attempt; 6 (20.0%) had self-injurious behavior without suicidal intent; 8 (26.7%) reported an interrupted attempt; 7 (23.3%) reported an aborted attempt; 10 (33.3%) had made preparations or showed suicidal behavior; 4 (13.3%) made suicide attempts during their period of deprivation of liberty, of which 3 (10.0%) attempted suicide for the first time during their period of deprivation of liberty. In the inferential analysis, the main variables associated with suicidal ideation and behaviors were the following: suicidal ideation before being deprived of their liberty, suicidal ideation during their period of deprivation of liberty, treatment for a mental health disorder, victim of sexual violence, attempted suicide, and active suicidal ideation with a method (not plan) without intent to act. Considering the results of this research and the expectations of the nursing team in the prison system, it can be concluded that it is important to evaluate suicidal ideation and behaviors among women deprived of liberty from the moment they are admitted, during the period in which they are deprived of their liberty as well as the aspects related to the occurrence of such behaviors, aiming to offer nursing care during the prevention process, the episode itself and the rehabilitation process.

Fatores associados à depressão e ansiedade em nutricionistas na pandemia por COVID-19 / Factors associated with depression and anxiety in nutritionists in the COVID-19 pandemic

O objetivo foi investigar os fatores associados à depressão e/ou ansiedade em nutricionistas durante a pandemia por COVID-19. Estudo transversal com aplicação das escalas GAD-7 e PHQ-9. Dos 1.018 participantes 60,2% manifestaram rastreio positivo para depressão e/ou ansiedade, com maior força de associação para conflitos muito frequentes nas relações (OR = 11,11; IC95% 6,61;18,67), uso de medicação para dor (OR = 7,42; IC95% 4,67;11,79) e pensar sempre sobre a pandemia (OR = 6,5; IC95% 4,14;10,32). Não estar em tratamento psicoterápico (OR = 0,39; IC95% 0,27;0,560) e não estar em uso de medicamento psicotrópico (OR = 0,40; IC95% 0,26;0,60) foram associados a menores chances de rastreio positivo. O estudo resulta em conhecimento epidemiológico aplicável a ações de vigilância, prevenção e controle da ansiedade e depressão entre nutricionistas.

The objective was to investigate the factors associated with depression and/or anxiety and depression in nutritionists during the COVID-19 pandemic. Cross-sectional study with the application of the GAD-7 and PHQ-9 scales. 1,018 participated, of which 60.2% showed positive screening for depression and/or anxiety, with a greater strength of association for very frequent conflicts in relationships (OR = 11.11; 95%CI 6.61;18.67), use of pain medication (OR = 7.42; 95%CI 4.67;11.79) and always thinking about the pandemic (OR = 6.5; 95%CI 4.14;10.32). Not being under psychotherapeutic treatment (OR = 0.39; 95%CI 0.27;0.560) and not using psychotropic medication (OR = 0.40; 95%CI 0.26;0.60) were associated with lower odds of positive screening. This study results in epidemiological knowledge applicable to surveillance, prevention and control of anxiety and depression among nutritionists.

Association Between Suicidal Behaviour and Cannabis and Tranquilizer use, Depression, Aggression and Other Borderline Personality Traits Among Students in Sincelejo, Colombia

Objective: This objective of this study is to examine the association between suicidal behaviour and substance use, depression, aggressiveness and borderline personality traits among adolescents from Sincelejo, a rural city in the north of Colombia. Methods: This cross sectional study included 352 participants selected by purposive sampling, from a public and a private school located in Sincelejo, Sucre district, in the north of Colombia. Students ages ranged from 12 to 18 years old (mean, 15.09 ± 1.82). The participants completed three screening tools: a socio-demographic questionnaire, a screening instrument to collect information related to the frequency of use of some substances, such as tobacco and cannabis, and a self-report inventory to assess various personality and psychopathology domains. A series of t-tests, ANOVA and linear regression analyses were conducted. Results: Physical aggression (t = 7.74; p < 0.01), cognitive depression (t = 5.03; p < 0.01), affective depression (t = 8.24; p <0.01), affective instability (t = 3.46; p <0.01), few social relationships (t = 3.36; p < 0.01), self-harm (t = 3.45; p< .01), cannabis and tranquilizer use (t = 2.83; p < 0.05; and t = 2.37; p <0.05) had a significant independent relationship with suicidal behaviour. Aggression (t = 2.59; p <0.05), components of depression (t = 9.03; p <0.01) and borderline personality traits (t = 4.12; p <0.01) also predicted suicidal behaviour. Conclusions: More longitudinal studies are needed in this area to identify the causal relations between the factors studied and the suicidal behaviour of young people in Sincelejo.

Objetivo: El objetivo de este estudio es examinar la asociación del comportamiento suicida con el consumo de sustancias, síntomas depresivos, agresividad y rasgos de personalidad límite en adolescentes de Sincelejo (Sucre), una ciudad rural del norte de Colombia. Métodos: Este estudio transversal incluyó a 352 participantes seleccionados por muestreo intencional de una escuela pública y privada ubicada en Sincelejo, distrito de Sucre, en el norte de Colombia. Las edades de los estudiantes oscilaron entre los 12 y los 18 anos (media, 15,09 ± 1,82). Los participantes completaron 3 instrumentos de cribado: uno de datos sociodemográficos, uno sobre consumo de algunas sustancias, tales como tabaco y cannabis, y su frecuencia y un instrumento de autoinforme para evaluar varios dominios de la personalidad y algunas psicopatologías. Se realizaron una serie de pruebas de la t, ANOVA y análisis de regresión lineal. Resultados: La agresión física (t = 7,74; p <0,01), el componente cognitivo de la depresión (t = 5,03; p <0,01), el componente afectivo de la depresión (t = 8,24; p <0,01), la inestabilidad afectiva (t = 3,46, p < 0,01), las pocas relaciones sociales (t = 3,36, p < 0,01), las autolesiones (p <0,01; t = 3,45, p <0,01), el cannabis (t = 2,83; p <0,05) y la toma de tranquilizantes (t = 2,37; p <0,05), se asociaron con el comportamiento suicida. La agresión (t = 2,59; p <0,05), los componentes de la depresión (t = 9,03; p <0,01) y los rasgos de personalidad límite (t = 4,12, p <0,01) predijeron el comportamiento suicida. Conclusiones: Se requieren más estudios longitudinales en esta área con el fin de identificar las relaciones causales entre los factores estudiados y el comportamiento suicida de los jóvenes en Sincelejo.

Depressive symptoms and alcohol and marijuana use among adolescents / Sintomas depressivos e uso de álcool e maconha em adolescentes / Síntomas depresivos y uso de alcohol y marihuana en adolescentes

Risk behaviors are common in adolescence and demonstrates an association with depressive symptoms. Considering the psychological health implications of this phase in adult life, the aim of this study was to verify associations between depressive symptoms and consumption of alcohol and marijuana, self-injurious behavior, health self-perception, life satisfaction, anxiety symptoms and suicidal ideation in adolescents. A total of 298 adolescents, aged 12 to 14 years (61.1% girls), participated in the study. The measures were the translated Health Behavior in School-aged Children questionnaire (HBSC - BR) and the Children's Depression Inventory (CDI). The chi-square test, student's t test and binomial logistic regression (p<0.05) were used. Depressive symptoms were associated with anxiety symptoms and self-injury. Higher risk for alcohol use and consumption, self-injury, negative health self-perception, anxiety and depression related to females. The findings of this population suggest worrying health outcomes, especially for girl. (AU)

Comportamentos de risco são comuns na adolescência e demonstram associação com sintomas depressivos. Considerando as implicações da saúde psicológica dessa fase na vida adulta, o objetivo deste trabalho foi verificar associações entre sintomas depressivos e consumo de álcool e maconha, comportamento autolesivo, autopercepção de saúde, satisfação com a vida, sintomas ansiosos e ideação suicida em adolescentes. Participaram 298 adolescentes, de 12 a 14 anos (61,1% meninas). Os instrumentos utilizados foram o questionário traduzido Health Behavior in School-aged Children (HBSC - BR) e o Inventário de Depressão Infantil (CDI). Utilizou-se os teste Qui-Quadrado, t de student e regressão logística binomial (p<0,05). Sintomas depressivos associaram-se com sintomas ansiosos e autolesão. Maior risco para uso e consumo de álcool, autolesão, autopercepção de saúde negativa, ansiedade e depressão em relação ao sexo feminino. Os achados desta população sugerem resultados preocupantes de saúde, sobretudo para o sexo feminino. (AU)

Las conductas de riesgo son comunes en la adolescencia y demuestran una asociación con síntomas depresivos. Considerando las implicaciones psicológicas para la salud de esta fase en la vida adulta, el objetivo de este estudio fue verificar asociaciones entre síntomas depresivos y consumo de alcohol y marihuana, autolesión, autopercepción de salud, satisfacción con la vida, ansiedad e ideación suicida en adolescentes. Participaron 298 adolescentes de 12 a 14 años (61,1% niñas). Los instrumentos utilizados fueron el cuestionario traducido Health Behavior in School-aged Children (HBSC - BR) y el Inventario de Depresión Infantil (CDI). Se utilizaron las pruebas de chi-cuadrado, t de Student y regresión logística binomial (p<0,05). Los síntomas depresivos se asociaron con síntomas de ansiedad y autolesiones. Mayor riesgo de uso y consumo de alcohol, autolesiones, autopercepción negativa de la salud, ansiedad y depresión en relación con el sexo femenino. Los hallazgos de esta población sugieren resultados de salud preocupantes, especialmente para las mujeres. (AU)

Team sports as a protective factor against mental health problems and suicidal ideation in adolescents / El deporte colectivo como factor protector ante problemas de salud mental e ideación suicida en adolescentes

Abstract Introduction Adolescents who practice sports have better mental health indicators. Objective To analyze the association between different types of physical activity (systematized exercise, individual, and collective sports), mental health, and suicidal ideation in adolescents. Method We conducted a cross-sectional study with 666 Brazilian adolescents (14-19 y.o.) attending high schools and selected using random cluster sampling. The mental health indicators analyzed were evaluated through the Self Reporting Questionnaire and the Strengths and Difficulties Questionnaire, including suicidal ideation. We also obtained physical activity information through questionnaires. Results There was a higher prevalence related to mental disorders (54.2% vs. 32.5%), difficulties related to mental health (79.6% vs. 48.4%), and suicidal thoughts (22.9% vs. 11.4%) in girls than in boys (p < .001 for all). The boys engaged in more team sports (41.0 vs. 23.8), whereas girls performed more exercise (45.1 vs. 26.5; p < .001). Discussion and conclusion The practice of team sports helps develop the collective spirit, stimulates social interaction, and develops reasoning and emotional intelligence. Boys who play team sports have fewer symptoms of common mental disorders, lower mental health problems, and less suicidal ideation than physically inactive boys.

Resumen Introducción Los adolescentes que practican deportes tienen mejores indicadores de salud mental. Objetivo Analizar la asociación entre los diferentes tipos de actividad física (ejercicio sistematizado, deportes individuales y colectivos), la salud mental y la ideación suicida en adolescentes. Método Se realizó un estudio transversal realizado con 666 adolescentes brasileños (14-19 años) que asisten a escuelas secundarias y fueron seleccionados mediante muestreo aleatorio por conglomerados. Los indicadores de salud mental analizados fueron evaluados a través del Cuestionario de Autoinforme y el Cuestionario de Fortalezas y Dificultades, incluyendo la ideación suicida. También obtuvimos información de la actividad física a través de cuestionarios. Resultados Hubo una mayor prevalencia relacionada con trastornos mentales (54.2% contra 32.5%), dificultades relacionadas con la salud mental (79.6% contra 48.4%) y pensamientos suicidas (22.9% contra 11.4%) en niñas que en niños (p < .001 para todos). Los chicos practicaban más deportes de equipo (41.0 contra 23.8), mientras que las chicas hacían más ejercicio (45.1 contra 26.5; p < .001). Discusión y conclusión La práctica de deportes de equipo ayuda en el desarrollo del espíritu colectivo, estimula la interacción social, desarrolla el razonamiento y la inteligencia emocional. Los niños que practican deportes de equipo tienen menos síntomas de trastornos mentales comunes, menos problemas de salud mental y menos ideación suicida en comparación con los niños físicamente inactivos.

Valoración de algunos indicadores del programa de atención a la conducta suicida en adolescentes / Evaluation of Some Indicators of the Program of Attention to Suicidal Behavior in Adolescents

Introducción: El suicidio está entre las tres primeras causas de muerte en el grupo de adolescentes y adultos jóvenes, su incidencia no ha descendido en el presente siglo. Objetivo: Valorar algunos indicadores relevantes del programa de atención a la conducta suicida en adolescentes. Métodos: Investigación en sistema y servicios de salud con diseño de estudio observacional descriptivo en tres áreas de salud del municipio Cienfuegos: áreas V, VII y VIII, de enero a septiembre del 2019. El universo fue de 46 profesionales de los Equipos de Salud Mental y Equipo Básicos de Salud. Se utilizaron como instrumentos dos encuestas, diseñadas y validadas por criterio de experto. Fueron seleccionados 6 indicadores en las dimensiones estructura y proceso y 4 en resultado. Se utilizó una media ponderada para procesar los datos. Resultados: Los indicadores valorados de regular fueron: en la estructura: capacitación de los recursos humanos y capacidad técnica del personal; en el proceso: confección de las historias clínicas, diseminación del programa en las unidades de salud y su verificación y las modalidades terapéuticas; y en resultado: la participación del equipo de salud mental en las investigaciones relacionadas con la conducta suicida. Conclusiones: Existe un grupo de deficiencias que conlleva a que el cumplimiento del programa de atención a la conducta suicida en adolescentes sea valorado como regular, en las tres áreas de salud del municipio Cienfuegos estudiadas(AU)

Introduction: Suicide is among the first three causes of death in the group of adolescents and young adults; its incidence has not decreased in the present century. Objective: To assess some relevant indicators of the adolescent suicidal behavior care program. Methods: Research in health system and services with descriptive observational study design in health areas V, VII and VIII of Cienfuegos municipality from January to September 2019. The universe was 46 professionals of the Mental Health Teams and Basic Health Team. Two surveys were used as instruments, designed and validated by expert criteria. Six indicators were selected in the structure and process dimensions and four in outcome. A weighted average was used to process the data. Results: The indicators rated as fair were: in the structure: training of human resources and technical aptitude of personnel; in the process: preparation of clinical histories, dissemination of the program in health units and its verification and therapeutic modalities; and in the outcome: participation of the mental health team in research related to suicidal behavior. Conclusions: There is a group of deficiencies that leads to the fact that compliance with the program of attention to suicidal behavior in adolescents is valued as regular in the three health areas of the Cienfuegos municipality studied(AU)

Ideación e intento suicida en pacientes con padecimientos psiquiátricos en un hospital de la Ciudad de México / Suicidal ideation and suicide attempt in patients with psychiatric disorders in a Mexico City hospital

Resumen Antecedentes: Uno de los grupos poblacionales en mayor riesgo de suicidio lo constituyen las personas que asisten a instituciones de salud mental. Objetivo: Conocer las características demográficas y clínicas de las personas ingresadas por ideación e intento suicida al área de observación de un hospital psiquiátrico en un periodo de 10 meses no consecutivos. Material y métodos: Estudio retrospectivo, descriptivo y correlacional. Se recabaron 439 expedientes, de los cuales las mujeres representaron 62.9 % (n = 276), los hombres 36.7 % (n = 161) y las personas transgénero 0.5 % (n = 2); el rango de edad varió de 17 a 74 años. Resultados: La mayor incidencia de casos se observó entre los 18 y 25 años, el diagnóstico más frecuente fue el trastorno depresivo y 45.5 % (n = 200) de los casos presentó una tentativa suicida. El principal método para cometer un acto suicida fue el envenenamiento por diversos medicamentos seguido por las lesiones autoinflingidas con objeto punzocortante. Se encontró correlación positiva entre intento suicida y autolesiones (χ2 = 1.965, p < 0.05). Conclusiones: Los hallazgos resaltan la importancia de la identificación temprana de los factores de riesgo que pueden contribuir al incremento del comportamiento suicida.

Abstract Background: One of the population groups at higher risk of suicide is that of people who attend mental health institutions. Objective: To know the demographic and clinical characteristics of people admitted for suicidal ideation and suicide attempt to the observation area of a psychiatric hospital in a period of 10 non-consecutive months. Material and methods: Retrospective, descriptive, correlational study. A total of 439 medical records were collected, out of which 62.9% (n = 276) corresponded to women, 36.7% (n = 161) to men and 0.5% (n = 2) to transgender people; age ranged from 17 to 74 years. Results: The highest incidence of cases was observed between 18 and 25 years of age; the most frequent diagnosis was depressive disorder, and 45.5% (n = 200) of the cases had a suicide attempt. The main method for committing a suicidal act was poisoning by taking various medications, followed by self-inflicted injuries with sharp objects. A positive correlation was found between suicide attempt and self-harm (χ2 = 1.965, p < 0.05). Conclusions: The findings highlight the importance of early identification of risk factors that may contribute to an increase in suicidal behaviors.

Evidencias psicométricas de la Escala de Ideación Suicida de Roberts en adolescentes peruanos / Psychometric evidence of the Roberts Suicidal Ideation Scale in Peruvian adolescents

Resumen La ideación suicida consiste en pensamientos relacionados con la muerte, con o sin planificación del lugar o los métodos que se utilizarán. Se ha evidenciado que la ideación suicida es más prevalente en la adolescencia, una etapa crucial durante el desarrollo del ser humano. Identificar e intervenir estos problemas es de suma importancia y los instrumentos psicométricos de evaluación son una herramienta complementaria en la práctica clínica o investigación básica. El objetivo de este estudio fue presentar las fuentes de evidencias de validez de la Escala de Ideación Suicida de Roberts en adolescentes peruanos. El diseño fue instrumental y participaron 399 adolescentes residentes en Lima, el 59.4 % eran mujeres, la edad promedio fue 17.81 (DE = 1.03) en un rango de 15 a 19 años. Asimismo, se realizaron preguntas adicionales sobre el comportamiento suicida durante los últimos 12 meses, a las cuales el 2.8 % respondió que consideró suicidarse y el 2.5 % que hizo planes de suicidio o intentó suicidarse, pero no tuvo éxito. Por otro lado, los resultados de la investigación sugieren una estructura factorial unidimensional (CFI = .99; RMSEA = .04 [90 % CI; .00-.12], SRMR = .01, WRMR = .30), adecuada consistencia interna (ω = .84) y de constructo (H = .94), coherente relación con otras variables e invarianza de acuerdo con el sexo y la edad (ΔCFI < .01; ΔSRMR < .03). Los hallazgos permiten concluir que las puntuaciones de la escala para el uso específico en adolescentes peruanos y comparación de grupos (sexo y edad) son confiables y adecuadas.

Abstract Suicidal ideation are thoughts related to death, with or without planning the place or the methods that would be used to kill oneself. Suicidal ideation has been shown to be more prevalent in adolescence, a crucial stage during human development. Identifying and intervening these problems is of utmost importance to prevent suicidal behaviors and the comorbidity of other psychological problems that can worsen the mental and physical health of the adolescent. A complementary tool in clinical practice or basic research are psychometric instruments that allow evaluating non-observable constructs in the field of psychology, for example, suicidal ideation. Therefore, the objective of the study was to present the sources of validity evidence based on the content, internal structure and in the relationship with other variables of the Roberts Suicidal Ideation Scale in Peruvian adolescents. Suicidal ideation are thoughts related to death, with or without planning the place or the methods that would be used to kill oneself. Suicidal ideation has been shown to be more prevalent in adolescence, a crucial stage during human development. Identifying and intervening these problems is of utmost importance to prevent suicidal behaviors and the comorbidity of other psychological problems that can worsen the mental and physical health of the adolescent. A complementary tool in clinical practice or basic research are psychometric instruments that allow evaluating non-observable constructs in the field of psychology, for example, suicidal ideation. Therefore, the objective of the study was to present the sources of validity evidence based on the content, internal structure and in the relationship with other variables of the Roberts Suicidal Ideation Scale in Peruvian adolescents. The study has an instrumental and cross-sectional design. 399 adolescents residing in Lima participated, selected through convenience sampling and inclusion criteria: a) be between 10 and 19 years old, b) place of residence in Lima and c) have accepted informed consent. Adolescents who did not meet these criteria were excluded from the study. All participants answered three scales, which were: the Roberts Suicidal Ideation Scale, the Paykel Suicidal Ideation Scale and the Rosenberg Self-Esteem Scale. The last two scales have evidence of validity in the Peruvian adolescent population. In that sense, 237 (59.4 %) were women and 162 (40.6 %) were men. The mean age was 17.81 (SD = 1.03) in a range of 15 to 19 years. Likewise, additional questions were asked about suicidal behavior during the last 12 months, where 2.8 % considered seriously committing suicide, 2.5 % made suicide plans, and 2.5 % attempted suicide, but were unsuccessful. Regarding the results of the investigation. In principle, three Peruvian psychologists reviewed the content of the items and all considered that the items were representative and relevant to explain the construct. Likewise, through the modeling of structural equations, a confirmatory factor analysis (CFA) was applied to analyze the internal structure of the scale, where it was evidenced that the structure was essentially one-dimensional (CFI = .99; RMSEA = .04 [90 % CI; .00-.12], SRMR = .01, WRMR = .30) and presented factorial loads (λ) higher than .50. On the other hand, the internal consistency was acceptable ω = .84 [95 % CI: .81-.86] and reliability of the construct H = .94, showing that the items are homogeneous and coherent. The multigroup measurement invariance and its different conditions (configural, metric and strong) according to sex (women vs. men) and age (15 to 17 years vs. 18 to 19 years), was stable in the different restrictions and fulfilling the points of Suggested. Cut-off for the variation of the fit índices: (ΔCFI < .01; ΔSRMR < .03), showing that the internal structure of the instrument is the same for the sex and age groups. Finally, a positive relationship was found (r = .35; p = .01) with another instrument that assesses suicidal ideation (thoughts of death, suicidal ideation and suicide attempt) and negative relationships with the positive dimension (r = -.31; p = .01) and negative dimension (r = -.25; p = .01) of self-esteem. All correlations had a minimal effect size. The research results suggest a one-dimensional factorial structure, adequate internal and construct consistency, coherent relationship with other variables and invariance according to sex and age. The findings allow us to conclude and recommend of the Roberts Suicidal Ideation Scale scores for the specific use in Peruvian adolescents and comparison of groups (sex and age) are reliable and adequate.

Depression, suicide ideation, and irrational beliefs: Explanatory models in psychology students / Depresión, ideación suicida y creencias irracionales: modelos explicativos en estudiantes de psicología

Abstract Introduction In rational emotive behavioral therapy, irrational beliefs are significant in mental health since their presence leads to conditions such as depression and suicidal ideation. Since these conditions have been increasing worldwide, it is essential to explore the factors that contribute to their understanding. Objective To design explanatory models for depression and suicidal ideation based on irrational beliefs in psychology students. Method Quantitative, non-experimental, cross-sectional study with multivariate analysis. Results Two explanatory models were designed: one for depression and the other for suicidal ideation. Thirty-nine per cent of depressive symptomatology can be explained by the presence of irrational beliefs concerning perfectionism, avoidance of responsibilities, concern over the future, and the determinism of the past. At the same time, 54% of suicidal ideation can be explained by the presence of beliefs centering on perfectionism, avoidance of responsibilities, external locus of control, and the determinism of the past. Discussion and conclusion Depression and suicidal ideation in psychology students can partly be explained by irrational beliefs concerning perfectionism, external locus of control, concern over the future, avoidance of responsibilities, and the determinism of the past. Clinical care approaches can modify these beliefs to reduce symptoms and promote mental health.

Resumen Introducción Para la terapia racional emotiva conductual las creencias irracionales tienen un gran peso en la salud mental, ya que la presencia de estas genera padecimientos como depresión e ideación suicida. Se sabe que en el mundo estos padecimientos han ido en aumento, por ello, es importante explorar factores que faciliten su explicación. Objetivo Generar modelos explicativos para la depresión y la ideación suicida desde las creencias irracionales en estudiantes de psicología. Método Estudio cuantitativo, no experimental, transversal con análisis multivariado. Resultados Se realizaron modelos explicativos; uno para la depresión y otro para ideación suicida. La sintomatología depresiva se explica en 39% con la presencia de creencias irracionales de perfeccionismo, evitación de responsabilidades, preocupación por el futuro y determinismo del pasado. Por otro lado, la ideación suicida se explica en 54% con la presencia de las creencias de perfeccionismo, evitación de responsabilidades, locus de control externo y determinismo del pasado. Discusión y conclusión La depresión e ideación suicida en estudiantes de psicología se puede explicar en parte por creencias irracionales de perfeccionismo, locus de control externo, preocupación por el futuro, evitación de responsabilidades y determinismo del pasado. A través de enfoques de atención clínica es factible modificar dichas creencias con el objetivo de disminuir sintomatología y promover la salud mental.

Análisis de red del maltrato infantil e ideación suicida en adolescentes peruanos

Introducción: El maltrato infantil es considerado un importante problema de salud pública debido a su impacto perjudicial en la salud física y psicológica de los adolescentes. La exposición a diversos tipos de maltrato puede conducir a otros problemas psicológicos, incluido la ideación suicida y es necesario identificar qué tipo de maltrato evidencia mayor asociación. Objetivo: Analizar la asociación entre el maltrato infantil y la ideación suicida en adolescentes peruanos de población general. Métodos: Estudio transversal cuantitativo. Participaron 1 379 adolescentes peruanos que contestaron instrumentos sobre maltrato infantil e ideación suicida. Se estimó un modelo de red gaussiano y se calcularon sus propiedades globales y locales. Además, para la comparación de grupos, se realizó la invarianza de estructura, fuerza global y aristas. Resultados: El maltrato emocional presentó mayor asociación con la ideación suicida y maltrato físico. Además, la ideación suicida se asoció de manera directa con el maltrato sexual y en menor magnitud con el maltrato físico. La mayor centralidad en la red fue para el maltrato emocional e ideación suicida. Tanto para hombres y mujeres, el maltrato emocional fue el nodo con mayor centralidad, aunque la diferencia surge en las mujeres con la presencia de ideación suicida y en los hombres el maltrato físico. Conclusiones: Los resultados confirman la importancia de evaluar los distintos tipos de maltrato infantil en adolescentes de población general, aunque de manera específica se destaca la valoración del maltrato emocional debido a su fuerte asociación con la ideación suicida, independientemente de si son hombres o mujeres.

Introduction: Child abuse is considered an important public health problem due to its detrimental impact on physical and psychological health in adolescents. Exposure to various types of abuse can lead to other psychological problems, including suicidal ideation, which is necessary to identify which type of maltreatment evidence more association. Objective: To analyze the association between child abuse and suicidal ideation in Peruvian adolescents from general population. Methods: Cross-sectional study with a quantitative approach. A total of 1 379 Peruvian adolescents participated, answered instruments about child abuse and suicidal ideation. A Gaussian network model was estimated, calculating its global and local properties. In addition, for the comparison of groups, structure invariance, global strength and edges were performed. Results: Emotional abuse present stronger partnership with suicidal ideation and physical abuse. In addition, suicidal ideation was directly associated with sexual abuse and to a lesser extent with physical abuse. The greatest centrality in the network was for emotional abuse and suicidal ideation. For both men and women, emotional abuse was the node with the highest centrality, although the difference arises in women with the presence of suicidal ideation and in men with physical abuse. Conclusions: The results confirm the importance of assessing the various types of child abuse in adolescents in general population, although the assessment of emotional abuse is specifically highlighted due to its strong association with suicidal ideation, regardless of whether if they are male or female.

Razões para viver e risco do suicídio em graduandos de uma universidade pública de Pernambuco / Reasons for living and the meaning of suicide in graduandos of a public university of Pernambuco / Razões para vivir y el significado del suicidio en graduandos de una universidad pública de Pernambuco

Objetivo: Investigar as Razões para Viver e os riscos da ideação suicida para os graduandos da Universidade de Pernambuco. Métodos: Trata-se de uma pesquisa quantitativa com caráter descritivo realizada nas instituições do Campus Santo Amaro com 359 acadêmicos. A coleta de dados foi realizada através de dois instrumentos autoaplicáveis: um questionário sociodemográfico e a Escala de Razões para Viver. Os dados foram digitalizados em planilhas eletrônicas, o tratamento estatístico foi realizado no programa Excel. Resultados: Constatou-se que 46,52% dos acadêmicos possuem risco médio para a ideação suicida, ressalta-se ainda que um percentual de 3,62% dos estudantes teve risco elevado para o pensamento suicida. Conclusão: Tais achados constituem tanto como um diagnóstico situacional, para que as instituições de ensino superior promovam programas e estratégias voltados para a prevenção da ideação suicida e a redução de fatores de risco, tal como para que os docentes atuantes, dentro do campus ou os que assistem os estudantes fora dele, tenham conhecimento da importância de medidas que visem identificar e minimizar tal situação, melhorando assim o ambiente acadêmico. (AU)

Objective: To investigate the meaning of suicidal ideation for undergraduate at the University of Pernambuco. Methods: This is a quantitative research with descriptive character carried out in the institutions of the Campus Santo Amaro with 359 academics. Data collection was performed through two self-applied instruments: a sociodemographic questionnaire and the Scale of reasons to live. The data were scanned in spreadsheets, the statistical treatment was performed in the Excel program. Results: It was found that 46.52% of the students had a moderate risk for suicidal ideation. It was also noted a percentage of 3.62% of the students risk for suicidal thoughts. Conclusion: These findings constitute both a situational diagnosis, so that higher education institutions promote programs and strategies aimed at the prevention of suicidal ideation and the reduction of risk factors, such as for active teachers, on campus or which assist students outside of it, are aware of the importance of measures aimed at identifying and minimizing such situation, thus improving the academic environment. (AU)

Objetivo: Investigar el significado de laideación suicida para los graduandos de laUniversidad de Pernambuco. Métodos: Se trata de una investigacióncuantitativacon carácter descriptivo realizada enlasinstitucionesdel Campus Santo Amaro con 359 académicos. La recolección de datosfue realizada a través de dos instrumentos autoaplicables: uncuestionario sociodemográfico y la Escala De Razones para Vivir. Los datosfueron digitalizados enhojas de cálculo, eltratamiento estadístico fue realizado enel programa Excel. Resultados: Se constató que el 46,52% de los académicos poseenriesgopromedio para laideación suicida, se resaltaaún que unporcentajedel 3,62% de losestudiantestuvieronunriesgo elevado para elpensamiento suicida. Conclusión: Tales hallazgosconstituyen tanto como un diagnóstico situacional, para que lasinstituciones de enseñanza superior promuevan programas y estrategias dirigidos a laprevención de laideación suicida y lareducción de factores de riesgo, tal como para que los docentes actuantes, dentro del campus o que asisten a losestudiantesfuera de él, tenganconocimiento de laimportancia de medidas que apunte a identificar y minimizar tal situación, mejorandoasíel ambiente académico. (AU)

Rasgos antisociales y neuroticismo como predictores de conducta suicida en trastorno límite de la personalidad: un estudio retrospectivo

Introducción: El espectro de la conducta suicida (CS) es nuclear en la clínica y el tratamiento del trastorno límite de personalidad (TLP). Los rasgos patológicos del TLP intervienen como factores de riesgo de CS en confluencia con otras variables clínicas y sociodemográficas asociadas con el TLP. El objetivo del presente trabajo consiste en evaluar los rasgos de personalidad específicos del TLP que se relacionan con la CS. Métodos: Se realiza un estudio transversal, observacional y retrospectivo, de una muestra de 134 pacientes con diagnóstico de TLP según los criterios del DSM-5. Se utilizan los cuestionarios de Millon-II, Zuckerman-Kuhlman y Barrat para valorar distintos parámetros de la personalidad. Se realizan comparaciones por variables mediante las pruebas de la x2 y de la t de Student. La asociación entre variables se analiza mediante regresión logística multivariada. Resultados: Se objetivan diferencias estadísticamente significativas entre la CS y relacionadas y la dimensión neuroticismo-ansiedad en el test de Zuckerman-Kuhlman. Asimismo se relaciona de manera significativa con la subescala fóbica y antisocial del Millon-II. La impulsividad medida con las pruebas de Zuckerman-Kuhlman y Barrat no aparece relacionada con la CS. Conclusiones: Los resultados presentados plantean el papel de los rasgos fóbicos, antisociales y del neuroticismo como posibles rasgos de personalidad del TLP relacionados con la CS. Incluso se propone una importancia mayor que el de la impulsividad dentro de la relación del TLP con la CS. De cara al futuro, estudios longitudinales permitirían aumentar la evidencia científica de los hallazgos presentados. © 2021 Asociación Colombiana de Psiquiatría. Publicado por Elsevier Espafña, S.L.U. Todos los derechos reservados.

Introduction: The spectrum of suicidal behaviour (SB) is nuclear in the clinic andmanagement of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB. Methods: A cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman-Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the test and the Student's t-test. The association between variables was analysed using multivariate logistic regression. Results: Statistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman-Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman-Kuhlman and Barrat tests does not appear to be related to SB. Conclusions: The results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings. © 2021 Asociacio´n Colombiana de Psiquiatria. Published by Elsevier España, S.L.U. All rights reserved.

Sobredosis de acetaminofén y comportamientos relacionados con suicidio / Acetaminophen overdose and suicide-related behaviors / Overdose de paracetamol e comportamentos suicidas

Objetivo: este trabajo busca caracterizar el comportamiento relacionado con el suicidio en la población admitida al Hospital San Vicente Fundación, Rionegro, con sobredosis de acetaminofén entre enero 2019 y diciembre 2020 y detectar factores asociados con la dosis tóxica. Metodología: análisis descriptivo con información obtenida de historias clínicas. Resultados: 63 individuos presentaron ingestión aguda de dosis tóxica de acetaminofén como comportamiento relacionado con suicidio. Cuarenta y tres eran mujeres, 60% tenía antecedente de enfermedad psiquiátrica, 35% reportó al menos un intento suicida previo y 22% consumieron 25g o más. La lesión hepática aguda se asoció con una dosis tóxica. Conclusiones: evidenciamos una alta prevalencia de antecedente de enfermedad psi­quiátrica y comportamiento relacionado con suicidio y casi un tercio de los pacientes ingirió dosis mayores al umbral de riesgo para falla hepática. Además, la impulsividad e ingesta en casa sugiere que políticas públicas restrictivas pueden no impactar en la reducción de estos eventos en la población.

Objective: this work seeks to characterize the behavior related to suicide in the po­pulation admitted to the Hospital San Vicente Fundación, Rionegro, with an overdose of acetaminophen between January 2019 and December 2020, and to identify factors associated with the toxic dose. Methodology: descriptive analysis with information obtained from medical records. Results: 63 individuals presented acute ingestion of a toxic dose of acetaminophen as behavior related to suicide. Forty-three were women, 60% had a history of psychiatric illness, 35% reported at least one previous suicide attempt, and 22% consumed 25g or more. Acute liver injury was associated with a toxic dose. Conclusions: we evidenced a high prevalence of a history of psychiatric illness and beha­vior related to suicide; almost a third of the patients ingested doses greater than the risk threshold for liver failure. In addition, impulsiveness and eating at home suggests that res­trictive public policies may not have an impact on reducing these events in the population.

Objetivo: Este trabalho busca caracterizar o comportamento relacionado ao suicídio na população internada no Hospital San Vicente Fundación, Rionegro, com overdose de acetaminofeno entre janeiro de 2019 e dezembro de 2020 e detectar fatores associados à dose tóxica. Metodologia: análise descritiva com informações obtidas dos prontuários. Resultados: 63 indivíduos apresentaram ingestão aguda de dose tóxica de paracetamol como comportamento relacionado ao suicídio. Quarenta e três eram mulheres, 60% tinham histórico de doença psiquiátrica, 35% relataram pelo menos uma tentativa de suicídio anterior e 22% consumiram 25g ou mais. A lesão hepática aguda foi associada a uma dose tóxica. Conclusões: evidenciamos alta prevalência de história de doença psiquiátrica e com-portamento relacionado ao suicídio e quase um terço dos pacientes ingeriu doses superiores ao limiar de risco para insuficiência hepática. Além disso, a impulsividade e a alimentação em casa sugerem que políticas públicas restritivas podem não ter impacto na redução desses eventos na população.

Major depressive disorder as a risk factor for suicidal ideation for attendees of educational institutions: a meta-analysis and meta-regression / Transtorno depressivo maior como fator de risco para ideação suicida em alunos de instituições educacionais: uma metanálise e metarregressão

Abstract Objective: This study aimed to analyze the effect of major depressive disorder (MDD) as a risk factor for suicidal ideation in individuals whose ages varied from 11 to 24 years and who were attending educational institutions. Data source: A systematic review was carried out by searching in PubMed and Biblioteca Virtual em Saúde (BVS). Original studies conducted in educational institutions, including individuals whose age varied from 11 to 24 years, in English, Spanish, or Portuguese were included. Data synthesis: Eight studies were selected for the meta-analysis, including 35,443 youths, with an average age of 16.8 years, predominantly female (51.2%), and from middle-income Asian countries (91.6%). An odds ratio of MDD of 3.89 (95%CI 2.46-6.17) for suicide ideation in youth was found. Subgroup analysis showed higher effects in Asia (OR=4.71; 95%CI 3.22-6.89) than Americas (OR=1.71; 95%CI 1.44-2.03). The meta-regression model indicated that younger adolescents (coef=-0.63; 95%CI 1.09--0.18; p<0.01) and older studies (coef=-0.23; 95%CI 0.039--0.08; p<0.01) presented higher effects of MDD on suicidal ideation. Conclusions: Early detection and treatment of MDD in youth patients are of utmost importance for preventing suicidal ideation. Educational institutions could play an important role in the early detection and intervention.

Resumo Objetivo: Analisar o efeito do transtorno depressivo maior (TDM) como fator de risco para a ideação suicida em indivíduos com idades entre 11 e 24 anos que frequentam instituições de ensino. Fontes de dados: Revisão sistemática realizada até agosto de 2020 por meio de buscas nas bases United States National Library of Medicine (PubMed) e Biblioteca Virtual em Saúde (BVS), sem limitações quanto à data de publicação. Síntese dos dados: Oito estudos foram selecionados para a metanálise, incluindo 35.443 jovens com idade média de 16,8 anos, predominantemente do sexo feminino (51,2%) e de países asiáticos de renda média (91,6%). Foi encontrado odds ratio (OR) de TDM de 3,89 (intervalo de confiança — IC95% 2,46-6,17) para a ideação suicida em jovens. A análise de subgrupo mostrou efeitos maiores na Ásia (OR=4,71; IC95% 3,22-6,89) do que nas Américas (OR=1,71; IC95% 1,44-2,03). O modelo de metarregressão demonstrou que adolescentes mais jovens (coef=-0,63; IC95% -1,09--0,18; p＜0,01) e estudos mais antigos (coef=-0,23; IC95% -0,039--0,08; p＜0,01) apresentaram maiores efeitos do TDM sobre a ideação suicida. Conclusões: Observou-se relação entre TDM e ideação suicida no continente asiático, entre adolescentes mais jovens e em estudos mais antigos.

The role of volume and intensity on the association between physical activity and mental health among adolescents: a cross-sectional study / O papel do volume e da intensidade na associação entre atividade física e saúde mental em adolescentes: um estudo transversal

Abstract Objective: To analyze the association between volume and intensity of physical activity and mental health among adolescents. Methods: Cross-sectional study with 604 Brazilian adolescents. Data were assessed using a self-report questionnaire. The outcomes were suicidal ideation, suspicion of common mental disorders, and negative self-perception of mental health. The independent variables were leisure physical activity at low and moderate-to-vigorous intensities. Volume was analyzed in two ways: any volume (presence vs absence), and volume classified according to amount in minutes of weekly physical activity: inactive (0), low active (1-419), and high active (≥420). Poisson regression was performed to estimate prevalence ratios. Results: Any volume of moderate-to-vigorous physical activity was significantly associated with a lower prevalence ratio of all outcomes (PR 0.67 to 0.77). Compared to inactive adolescents, those who were classified as low active for moderate-to-vigorous intensity, presented a lower likelihood of having suicidal ideation, suspicion of common mental disorders, and negative self-perception of mental health (PR 0.70 to 0.76). Furthermore, high active adolescents in moderate-to-vigorous physical activity presented lower suicidal ideation and negative self-perception of mental health (PR 0.62 and 0.57). Conclusions: The promotion of moderate-to-vigorous intensity physical activity at any volume can benefit the mental health of adolescents, however, no association was evidenced for low intensity physical activity.

Resumo Objetivo: Analisar a associação entre o volume e intensidade da atividade física e a saúde mental de adolescentes. Métodos: Estudo transversal que envolveu 604 adolescentes brasileiros. Os dados foram coletados por meio de um questionário autorrelatado. Os desfechos foram ideação suicida, suspeita de transtornos mentais comuns e autopercepção negativa de saúde mental. A variável independente foi a atividade física em tempo livre nas intensidades leve e moderada a vigorosa. O volume foi analisado de duas formas: qualquer volume (presença vs. ausência); e de acordo com a quantidade de atividade física semanal em minutos — inativos (0), pouco ativos (1-419) e altamente ativos (≥420). A regressão de Poisson foi realizada para estimar as razões de prevalência (RP). Resultados: Qualquer volume de atividade física de intensidade moderada a vigorosa foi significativamente associado à menor razão de prevalência de todos os desfechos (RP 0,67 a 0,77). Comparados aos adolescentes inativos, aqueles que foram classificados como pouco ativos na intensidade moderada a vigorosa apresentaram menor probabilidade de ter ideação suicida, suspeita de transtornos mentais comuns e autopercepção negativa de saúde mental (RP 0,70 a 0,76). Da mesma forma, adolescentes altamente ativos na intensidade moderada a vigorosa apresentaram menor ideação suicida e autopercepção negativa de saúde mental (RP 0,62 e 0,57). Conclusões: A promoção de atividade física moderada a vigorosa em qualquer volume pode beneficiar a saúde mental de adolescentes, no entanto nenhuma associação foi evidenciada para a atividade física na intensidade leve.