Fadiga em pacientes com câncer de cabeça e pescoço em tratamento radioterápico: estudo prospectivo / Fatigue in patients with head and neck cancer undergoing radiation therapy: a prospective study / Fatiga en pacientes con cáncer de cabeza y cuello en tratamiento radioterápico: estudio prospectivo

Objetivo identificar a frequência do sintoma de fadiga e domínios afetados nos pacientes com câncer de cabeça e pescoço em tratamento radioterápico, no início, meio e final do tratamento. Método estudo com delineamento quase experimental de corte longitudinal e prospectivo, envolvendo 60 pacientes com câncer de cabeça e pescoço. Destaca-se que este artigo somente abordará os dados do Grupo Controle. As variáveis dependentes foram coletadas por meio de entrevista, utilizando a Escala de Fadiga de Piper - revisada, cujo instrumento multidimensional avalia os domínios global, comportamental, afetivo e sensorial/psicológico. A análise dos dados baseou-se em frequências absolutas e relativas. Resultados houve predomínio do sexo masculino, faixa etária de 41-60 anos, baixa escolaridade e em uso regular de álcool e cigarro. Todos os domínios da escala de fadiga tiveram seus escores aumentados, apresentando valores medianos de maior magnitude em Tempo 2 e Tempo 3, quando comparados aos valores em Tempo 1, indicando aumento nos níveis de fadiga no decorrer do tratamento radioterápico. Conclusão o sintoma de fadiga aumentou no decorrer do tratamento radioterápico, tendo todos os domínios afetados, com isso, ressalta-se a importância da avaliação ao longo do tratamento, por se tratar de um sintoma frequente e debilitante aos pacientes oncológicos.

Objective to identify the frequency of fatigue and domains affected in patients with head and neck cancer undergoing radiation therapy, at the beginning, middle and end of treatment. Method longitudinal and prospective study of quasi-experimental design, involving 60 patients with head and neck cancer. It should be highlighted that this article will address only the data of the Control Group. The dependent variables were collected through interview, using the revised Piper Fatigue Scale, which is a multidimensional instrument that assesses global, behavioral, affective and sensory/psychological domains. Data analysis was based on absolute and relative frequencies. Results there was a predominance of males, age group between 41-60 years, low level of education and in regular use of alcohol and cigarettes. All domains in the fatigue scale had their scores increased, presenting median values of greater magnitude in Time 2 and Time 3, when compared to the Time 1 values, indicating an increase in fatigue levels during radiation therapy. Conclusion fatigue increased in the course of the radiation therapy, having all domains affected. Therefore, its evaluation throughout the treatment is important, as fatigue is a common and debilitating symptom on cancer patients.

Objetivo identificar la frecuencia del síntoma de la fatiga y los dominios afectados en los pacientes con cáncer de cabeza y cuello en tratamiento radioterápico, al inicio, medio y fin del tratamiento. Método estudio con diseño cuasiexperimental de corte longitudinal y prospectivo, que contó con la participación de 60 pacientes con cáncer de cabeza y cuello. Se resalta que este artículo se limitará a abordar los datos del Grupo Control. Las variables dependientes se recopilaron por medio de entrevista, y la fatiga se valoró con la Escala de Fatiga de Piper (revisada), cuyo instrumento multidimensional valora los dominios global, comportamental, afectivo y sensorial/psicológico. El análisis de los datos se basó en frecuencias absolutas y relativas. Resultados hubo predominio del sexo masculino, franja etaria entre 41 y 60 años, baja escolaridad y uso de alcohol y tabaco de forma regular. Todos los dominios de la escala de la fatiga tuvieron sus puntuaciones aumentadas, y presentaron valores medianos de mayor magnitud en Tiempo 2 y Tiempo 3, cuando se comparan con los valores en Tiempo 1, lo que indica un aumento en los niveles de fatiga en el transcurso del tratamiento radioterápico. Conclusión el síntoma de fatiga aumentó durante el tratamiento radioterápico, y todos los dominios se vieron afectados, con lo que se resalta la importancia de realizar la valoración a lo largo del tratamiento, por tratarse de un síntoma frecuente y que debilita a los pacientes oncológicos.

Degeneración quística de la arteria poplítea: Presentación de caso clínico / Cystic degeneration of the popliteal artery: Report of one case

Cystic degeneration of the popliteal artery is an uncommon cause of intermittent claudication. We report a 52 years old male consulting for intermittent claudication referred to the calf. The angiography showed a 93% stenosis in segment of 45 mm length of the left popliteal artery with a smooth surface, suggesting an extrinsic compression. A CT angiography of the lower limb suggested the presence of a cystic degeneration. The patient was operated and the middle third of the popliteal artery was excised. The pathological study of the surgical piece was informed as artery media cystic degeneration.

Scaling up Treatment for Co-morbid Mental Disorders

No abstract available.

Hazardous Drinking-Related Characteristics of Depressive Disorders in Korea: The CRESCEND Study

This study aimed to identify clinical correlates of hazardous drinking in a large cohort of Korean patients with depression. We recruited a total of 402 depressed patients aged > 18 yr from the Clinical Research Center for Depression (CRESCEND) study in Korea. Patients' drinking habits were assessed using the Korean Alcohol Use Disorder Identification Test (AUDIT-K). Psychometric scales, including the HAMD, HAMA, BPRS, CGI-S, SSI-Beck, SOFAS, and WHOQOL-BREF, were used to assess depression, anxiety, overall psychiatric symptoms, global severity, suicidal ideation, social functioning, and quality of life, respectively. We compared demographic and clinical features and psychometric scores between patients with and without hazardous drinking behavior after adjusting for the effects of age and sex. We then performed binary logistic regression analysis to identify independent correlates of hazardous drinking in the study population. Our results revealed that hazardous drinking was associated with current smoking status, history of attempted suicide, greater psychomotor retardation, suicidal ideation, weight loss, and lower hypochondriasis than non-hazardous drinking. The regression model also demonstrated that more frequent smoking, higher levels of suicidal ideation, and lower levels of hypochondriasis were independently correlates for hazardous drinking in depressed patients. In conclusion, depressed patients who are hazardous drinkers experience severer symptoms and a greater burden of illness than non-hazardous drinkers. In Korea, screening depressed patients for signs of hazardous drinking could help identify subjects who may benefit from comprehensive therapeutic approaches.

Study of Serum Selenium Levels in Schizophrenic Patients.

Deficiency and excess amount of trace elements play an important role in several well recognized diseases, studies are going on to establish their role in schizophrenia. Selenium and other trace elements are indispensable components for certain enzymes responsible for various metabolic processes in different tissues including the brain as they play important functional roles in peripheral and central nervous systems. Objectives: In this study, we examined the levels of selenium in serum of patients of schizophrenia and compare them with normal healthy controls. Selenium was also measured in acute and chronic stage of schizophrenia categorized on the basis of PANSS score and correlated by Spearman’s Correlation Coefficient (ρ) in total cases, acute cases and chronic cases. Method: The study population comprised 150 patients and 150 age matched controls. We measured levels of Selenium by AAS (Atomic Absorption Spectrophotometer). Results: We found that selenium levels were significantly lower in patients with schizophrenia than in the control group. The levels of micronutrients studied were also correlated with disease severity and duration but found non-significant relation. Conclusion: Evaluation of selenium levels in patients with schizophrenia could prove useful. There may be role of Selenium in the pathogenesis and course of Schizophrenia and new therapeutic approaches warrants further study.

Comportamiento del riesgo de caídas en el hogar en adultos mayores / Behavior of falls risk at home of the elderly persons

Introducción: se realizó un estudio descriptivo, en la población de adultos mayores atendidos por el Consultorio del Médico de Familia # 4, perteneciente al policlínico Ramón González Coro, del municipio Marianao, durante 2008. Objetivo: se realizó el análisis del comportamiento del riesgo de caídas de los adultos mayores en el hogar. Métodos: estudio de investigación descriptiva, en cuyo desarrollo se utilizó un modelo cualicuantitativo, y en su ejecución se emplearon métodos teóricos, empíricos y procedimientos estadísticos. Resultados: hubo un predomino del sexo femenino, el mayor por ciento de los adultos mayores presentó algún grado de dependencia, y tuvieron un mediano riesgo de sufrir una caída en su hogar

Introduction: a descriptive study was conducted in the elderly person population seen in the # 4 Family Physician Consulting Room of the Ramón González Coro polyclinic from the Marianao municipality during 2008. Objective: an analysis of the falls risk behavior of elderly persons at home was made. Methods: a descriptive research study was conducted using the qualitative and quantitative model and in its implementation theoretical, empirical methods as well as statistic procedures were used. Results: there was predominance of female sex, the higher percentage of elderly persons had some degree of dependence and also had a middle risk of suffering a fall at home

Validation of the children's depression rating scale- revised for adolescents in primary-care pediatric use in India.

Background: Adolescent depression needs to be identified and treated in the primary care settings. There is no clinician-rated measure validated in India for identifying depression among adolescents. Aim: We studied the diagnostic accuracy, reliability, and validity of Children's Depression Rating Scale - Revised (CDRS-R) for primary care pediatrics. Setting and Design: Prospective study in three schools in Southern India. Materials And Methods: Adolescents recruited were administered the CDRS-R by a pediatrician and clinical psychologist along with Beck Depression Inventory (BDI) for convergent validity. Impact of Event Scale (IES) for divergent validity and the ICD-10 clinical diagnosis of depressive disorders using modified Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) interview as reference standard were administered by a psychiatrist independently. Appropriate statistical analyses for diagnostic accuracy, reliability, and validity were done. Results: A cut-off score of 30 (sensitivity = 83%, specificity = 84%; AUC in ROC = 87%) in CDRS-R is suggested for diagnosing depression. The inter-rater reliability (r = 0.73) and test-retest reliability (r = 0.98) was good. In addition to the adequate face and content validity, CDRS-R had good internal consistency (α = 0.76), high convergent (r = 0.71; P = 0.001), and divergent validity (r = 0.28; P = 0.20). There was moderate concordance with the reference standard of ICD-10 diagnosis (45.5%) in identifying depression and CDRS-R discriminated 80% of the other psychiatric morbidity. The six-factor structure explained 60.6% of variance. Conclusion: The CDRS-R showed strong psychometric properties and is now available for use in the primary-care pediatric practice in India.

A Clinical Psychiatric Study of Non-Psychotic Young Adolescents.

Background : Only a few clinical psychiatric studies have been done on adolescents in India. Non-psychotic psychiatric disorders in Indian adolescents require greater clinical attention. Aim: To clinically evaluate, diagnose and classify non-psychotic adolescents, aged 13 to 16 years, attending the child and adolescent psychiatry OPD. Methods and Material : 40 subjects were assessed on Kiddie Schedule for Affective Disorder and Schizophrenia, Present and Lifetime version (K-SADS-PL) or clinically for non-psychotic clinical psychiatric disorders. ‘Parent Interview Schedule’ and ‘Interview Schedule for Children’ were used to assess abnormal psychosocial situations, and Children’s Global Assessment Scale for psychosocial disability. Subjects were diagnosed using ICD-10 DCR and ICD-10 multi-axial classification. Results: Common adolescent non-psychotic psychiatric disorders found were mood disorders (27.5%), conduct disorder (17.5%) and dissociative disorder (12.5%). 7.5% adolescents had a specific disorder of psychological development. Abnormal psychosocial situations were present in 40% of the adolescents. Nearly half the adolescents (47.5%) had moderate social disability. Comorbidity was present in 17.5% adolescents. Conclusion :Common imparing psychiatric disorders among young clinic adolescents were mood disorders, conduct disorders, and dissociative disorders. More and larger studies in Indian general population and clinic settings are needed in this age group.

Análisis factorial de la calidad de vida relacionada con la salud de pacientes que ingresan en una unidad de corta estancia médica / Factor analysis of health related quality of life in patients admitted to a short stay medical unit

Background: Disease and hospital admission have a great impact on the quality of life of an individual: Aim: To identify the factors associated with health related quality of life (HRQL) in patients admitted to a Short Stay Medical Unit (SSMU). Patients and methods: Prospective cohort study of 335 patients aged 15 to 99 years (196 males) consecutively admitted to the SSMU. In all we recorded sociodemographic data, number of previous hospital admissions, admission type, main diagnosis, ¡enght of stay, comorbidities, the Goldberg Depression and Anxiety Scale, the Karnofsky Perfomance Scale, the Barthel Index and quality of life with the EuroQol-5D instrument. After studying the associations between variables, we carried out a factor analysis of those that were significantly related to HRQL. Results: Mean body mass index was 27.7 Kg/m² and 83 percent were emergency admissions. Heart failure, chronic obstructive pulmonary disease exacerbation, acute coronary syndromes and cardiac arrhythmias, constituted 56 percent of all admissions. HRQL was statistically related to age, gender, educational status, caregiving situation, number of previous admissions, main diagnosis, length of stay, Goldberg scale and Karnofsky, Barthel and Charlson indexes. Factor analysis reduced the original variables to five, which explained 67.8 percent of the variance, as follows: Factor 1- Karnofsky and Barthel indexes (27.8 percent); Factor 2- age, educational status, caregiving situation (12.3 percent); Factor 3- the Goldberg scale (10.4 percent); Factor 4- admission type (8.8 percent); Factor 5- main diagnosis (8.4 percent). Conclusions: HRQL in patients admitted to Short Stay Medical Unit is partially related to perfomance status, age, social and psychological status, admission type an the main diagnosis (RevMéd Chile 2009; 137:1163-72).

Análisis preliminar y datos normativos del Cuestionario de Ansiedad Estado-Rasgo en adolescentes y adultos de la ciudad de Santiago de Chile / Preliminary analysis and normative Data of the State-Trait Anxiety Inventory (STAI) in adolescent and adults of Santiago, Chile

El estudio reporta los análisis preliminares y datos normativos, para una muestra de población general del Cuestionario de Ansiedad Estado Rasgo (Spielberger, Gorsuch & Lushene, 1970). Los datos fueron obtenidos de una muestra total de 1488 personas entre 13 y 60 años de edad. La consistencia interna obtenida fue .92, para STAI-S y .87 para STAI-R. Del análisis factorial confirmatorio se obtienen dos factores para cada escala. Finalmente, se realizan análisis de comparación de medias para la obtención de datos normativos, para la muestra total diferenciada por sexo y para la muestra de adolescentes y adultos.

The present study reports the preliminary analyses and normative data of the State-Trate anxiety inventory (Spielberger, Gorusch & Lushene, 1970), for a Chilean, general population sample. Data were obtained from a total sample of 1488 people, between 13 and 60 years old. A high internal consistency for STAI-S .92 and for STAI-T .87 is reported. Two factors were obtained from the confirmatory factorial analysis. Finally, analyses of the means were carried out, obtaining normative data for the total sample, differentiated by sex, and for the adolescents and adults sample.

Validación de la Escala de Depresión de Zung en personas con VIH / Validation of the Zung Depression Scale in persons with HIV

Se describen las propiedades psicométricas de la escala de depresión de Zung, que fue administrada a 62 personas con VIH que al momento del estudio eran vistos en el Centro Ambulatorio para la Prevención y Atención a VIH/SIDA e ITS en la ciudad de Hermosillo, México. La edad promedio de los participantes fue de 37,02 años, de los cuales 59,7 por ciento eran personas del sexo masculino y 40,3 por ciento del sexo femenino. Para la evaluación de las propiedades psicométricas de la escala se utilizaron en orden sucesivo los siguientes procedimientos: la prueba de la t de Student de comparación de medias para la comprensión de las preguntas; un análisis factorial exploratorio con rotación varimax para estudiar la validez de constructo y el coeficiente a de Cronbach para valorar la confiabilidad. Con la prueba de la t de Student se obtuvieron valores de significancia estadística en 19 de las 20 preguntas. El análisis factorial exploratorio arrojó una estructura de tres factores, con valores propios superiores a 1 y que en conjunto explican 56,13 por ciento) de la varianza. Finalmente, en el análisis de confiabilidad de la medida se obtuvo un a de Cronbach global de 0.887. Según los resultados obtenidos, la escala de depresión de Zung posee óptimas propiedades psicométricas de validez de constructo y confiabilidad en personas con VIH.

We describe the psychometric properties of the Zung's depression scale, which was administered to 62 persons with HIV who were being treated in the Ambulatory Center of Prevention and Attention at HIV/AIDS and STI in Hermosillo, Mexico. Participants mean age was 37.02 year old, 59.7 percent> were male and 40.3 percent> females. Three consecutive statistical testing procedures were applied for data analysis: the Student t test for comparison of means and for assesing the comprehensibility of the questions; an exploratory factorial analysis with varimax rotation for determining construct validity; Cronbach's a coefficient for determining reliability. In 19 out of a total of 20 questions, the Student t test for comparison of means gave statistically significant values. A three-factors structure was found with the factorial analysis, with values above 1 that, taken as a whole, explain 56.13 percent> of the variance. An overall a coefficient of 0.887 was obtained with the test of reliability. According with the results obtained, the Zung' depression scale has optimal psychometric properties of construct validity and reliability for people with HIV

Comorbidity of psychiatric disorders and symmetric distal polyneuropathy among type II diabetic outpatients

The objective of the present study was to establish the frequency of psychiatric comorbidity in a sample of diabetic patients with symmetric distal polyneuropathy (SDPN). Sixty-five patients with type 2 diabetes mellitus were selected consecutively to participate in the study at Instituto Estadual de Diabetes e Endocrinologia. All patients were submitted to a complete clinical and psychiatric evaluation, including the Portuguese version of the structured clinical interview for DSM-IV, the Beck Depression Inventory, the Neuropathy Symptom Score, and Neuropathy Disability Score. SDPN was identified in 22 subjects (33.8 percent). Patients with and without SDPN did not differ significantly regarding sociodemographic characteristics. However, a trend toward a worse glycemic control was found in patients with SDPN in comparison to patients without SDPN (HbA1c = 8.43 ± 1.97 vs 7.48 ± 1.95; P = 0.08). Patients with SDPN exhibited axis I psychiatric disorders significantly more often than those without SDPN (especially anxiety disorders, in general (81.8 vs 60.0 percent; P = 0.01), and major depression - current episode, in particular (18.2 vs 7.7 percent; P = 0.04)). The severity of the depressive symptoms correlated positively with the severity of SDPN symptoms (r = 0.38; P = 0.006), but not with the severity of SDPN signs (r = 0.07; P = 0.56). In conclusion, the presence of SDPN seems to be associated with a trend toward glycemic control. The diagnosis of SDPN in diabetic subjects seems also to be associated with relevant psychiatric comorbidity, including anxiety and current mood disorders.

Neuro-cognitive functions in patients of major depression.

Earlier studies have shown conflicting results regarding impairment of executive functions in patients of major depression. In the present study, subjects were divided into following groups-Group 1 (19 Males & 11 females, age 18-45 years) consisting of patients of major depression diagnosed on the basis of DSM IV criteria and Group 2 (20 Males & 10 females, age 18-45 years) consisting of healthy subjects who had been screened for any sub-psychiatric illness by standardized hindi version of Goldberg's General Health Questionnaire (G.H.Q.). All the Group 1 & Group 2 subjects were rated on Hamilton Rating Scale for Depression (HAM-D) and then administered Neuro-cognitive test battery consisting of Letter Cancellation test, Trail Making test 'A' & 'B', Ruff Figural Fluency test, Forward & Reverse Digit Span test for assessing following cognitive domains: Attention span, visuo-motor scanning, short term memory and executive functions like working memory, information manipulation, set-shifting strategy analysis etc. Results showed significant impairment on all the studied neuro-cognitive parameters in Group 1 subjects as compared to Group 2 subjects, which demonstrate significant impairment of attention, visuomotor speed, immediate verbal memory, short-term retentive capacity and executive functions (strategic planning, attentional set shifting and working memory) in patients of major depression. It may probably be due to the disruption of dorso-lateral prefrontal cortex (dlpfc) and orbito-frontal networks in patients of major depression.

Assessment of a modified Mini-Mental Scale for cognitive functions in children.

This study was conducted to standardize a clinical test to assess cognitive functions in children between 3-14 years and to evaluate its use in patients with encephalopathy. We included 50 children in Group A with non-neurological illness. Another 50 children were included in Group B with encephalopathy due to varied etiologies. The Mini Mental State Examination (MMSE) used in adults was modified, using tests from standardized assessment tools previously used in Indian children. It was administered independently by two observers at admission and after a few days in the two Groups. In Group A, the mean and SD of the score in various age groups were calculated. Sensitivity and specificity of the test in predicting poor outcome with a cut-off score of 10 was calculated at admission and after a mean of 4 days. The average time taken for the test was 6.03 minutes. No significant interobserver variability was found. Cut off abnormal scores calculated as 2 SD below mean in different age groups were 3 to 5 years 24, 6 to 8 years 28, 9 to 11 years 30, 12 to 14 years 35. In children with encephalopathy a score below 10 predicted poor outcome with a sensitivity of 35 percent and specificity of 100 percent at admission. Retest after 4 days had sensitivity and specificity of 68 percent and 100 percent respectively. We conclude that the modified Child MMSE may be used as a screening test to assess and monitor cognitive functions in children.

Depresión postparto: prevalencia de test de rastreo positivo en puérperas del Hospital Universitario de Brasilia, Brasil / Postpartum depression: positive search test prevalence in puerperal women at University Hospital of Brasilia, Brasil

Con la intención de estimar la prevalencia de depresión postparto en mujeres atendidas en el Hospital Universitario de Brasilia - Brasil, fue utilizada una versión en portugués de la Escala de Depresión Post Natal de Edimburgo (EPDS). La escala fue aplicada a mujeres que se encontraban entre la octava y décima segunda semana postparto, abordadas en los consultorios de Crecimiento y Desarrollo Pediátrico, donde llevaban a sus hijos para consulta pediátrica de rutina. Fue analizada la prevalencia de test positivo, así como la influencia de los antecedentes reproductivos y si el embarazo fue programado o accidental. Un total de 123 mujeres respondieron la escala; 6 fueron excluidas por dejar uno o más ítems sin respuesta. Hubo una prevalencia de test positivo de 22,2 por ciento. La edad, paridad, antecedentes de aborto o embarazo accidental no fueron factores de riesgo estadísticamente significativos para el hallazgo de test positivo.

Interrater agreement for the schedule for affective disorders and schizophrenia epidemiological version for school-age children (K-SADS-E)

OBJETIVE: The main objective of this study was to assess the interrater agreement for the Schedule for Affective Disorders and Schizophrenia Epidemiological version for School-Age Children (K-SADS-E). METHODS: Four interviewers being trained with the K-SADS-E scored independently 29 videotaped interviews performed with psychiatric outpatients in the ADHD Outpatient Clinic at Hospital de Clínicas de Porto Alegre. Interrater agreement analysis was performed using the kappa coefficient (k). RESULTS: Kappa coefficients were .93 (p<.001) for affective disorders, .9 (p<.001) for anxiety disorders, .94 (p<.001) for attention-deficit/hyperactivity disorders and disruptive behavior disorders. CONCLUSION: These findings suggest an excellent interrater agreement for the diagnosis of several mental disorders in childhood and adolescence by the Brazilian Portuguese version of the K-SADS-E

Prevalencia de trastornos psiquiátricos en hombres y mujeres hospitalizados en un servicio de medicina interna de un hospital de Santiago de Chile / Prevalence of psychiatric disorders among subjects hospitalized in a medicine ward of a general hospital

Background: Mental disorders may interfere, aggravate or mimic medical conditions. Aim: To study the prevalence of psychiatric disorders among patients hospitalized in a medical ward of a general hospital. Patients and methods: A structured interview for DSM-III, devised for "non patients", was applied to 203 men and 203 women, aged 11 to 90 years old, hospitalized in an internal medicine service of a public hospital. Thirty four psychiatric conditions that can be discriminated with the instrument and others that complied with DSM-III criteria, were investigated. Results: There was a 60 percent prevalence of mental disorders among men (alcohol dependency in 26 percent, delirium or dementia in 10.8 percent, anxiety disorders in 10.4 percent, major depression in 7.8 percent and adaptation disorders in 3 percent). Among women, the prevalence of mental disorders was 65 percent (major depression in 23.2 percent, anxiety disorders in 14.3 percent, adaptation disorders in 8.4 percent, dementia in 5.6 percent, delirium in 3 percent and alcohol dependency in 2.5 percent). Most conditions were of moderate or mild intensity. Two or more conditions coexisted in 40 percent of cases. Only in 8 percent of these subjects, a psychiatric consultation was requested. Conclusions: There is a high frequency of psychiatric disorders among medical patients. These must be adequately diagnosed and treated

Concordancia diagnóstica en depresión: Médicos psiquiatras versus médicos no psiquiatras / Diagnostic concordance in depression: Psychiatrist versus non-psychiatrists

Antecedentes . Los trastornos depresivos afectan en forma global a 21.7 por ciento de mujeres y a 12.7 por ciento de hombres. El abordaje actual de psiquiatría de Consulta y Enlace subraya la importancia de la precisión diagnóstica. Objetivo . Evaluar la concordancia diagnóstica entre psiquiatras y no-psiquiatras en el Hospital Central Militar de México. Método . La base de datos de Psiquiatría de Enlace (1989-1993) que consta de 1 300 consultas, fue evaluada atendiendo al establecimiento del diagnóstico de depresión por psiquiatras en comparación con no-psiquiatras. Se describen valores porcentuales, un índice de concordancia diagnóstica. Resultados . De acuerdo con el análisis de la muestra global, hay una discreta predominancia de mujeres deprimidas (51.7 por ciento) sobre hombres (48.3 por ciento), así como de la sala de medicina de mujeres como fuente de referencia. La razón principal de referencia fue la depresión (179 casos/13.7 por ciento). El servicio de Consulta y Enlace estableció el diagnóstico de depresión en 166 pacientes (12.7 por ciento) mismo que fue considerado como el estándar operativo de oro. Los médicos no-psiquiatras establecieron el diagnóstico de depresión en 179 casos, mostrando una confiabilidad diagnóstica de 86.7 por ciento, así como un sobrediagnóstico de 18.9 por ciento y una falla diagnóstica de 12.65 por ciento. Conclusiones . La confiabilidad diagnóstica de depresión por médicos no psiquiatras en el Hospital Central Militar es de 86.7 por ciento con base en este informe. Es importante continuar esta línea de investigación utilizando entrevistas estructuradas para confirmar los presentes resultados.