Beliefs of parents of children with mental disorders in a university hospital out-patient clinic in Colombia.

OBJECTIVE: Describe the beliefs of parents about the mental disorders of their children who attended a paediatric outpatient clinic at a university hospital. METHODS: This was a descriptive study with parents of children with mental disorders seen from January to May of 2018 at a high complexity hospital in Medellin, Colombia. Ninety-eight (98) parents of children and adolescents attending their first outpatient consultation with Paediatric Psychiatry were studied. An instrument designed by the investigators was applied to obtain demographic variables and beliefs about the origin of their child's mental disorder, treatment and adjuvants. RESULTS: 49.9% of the 98 parents believed that their child had a mental disorder. 43.9% believed the disorder was inherited and 41.8% believed its cause was organic. 95.9% of the parents believed the child needed treatment, including psychotherapy (90.4%) and medication (58.51%). Among the alternative treatments the parents believed the child needed, healing was the most commonly cited by 27.5% of the parents. Of the adjuvant methods, the most commonly cited were reinforcing positive behaviour (82.7%) and correcting with words and setting a good example (72.4%). CONCLUSIONS: Nearly half of the parents believed their child had a mental disorder, the treatment that was most commonly considered was psychotherapy above medication, and the best adjuvant methods cited by parents were reinforcing positive behaviour, correcting with words and setting a good example.

Creencias de los padres acerca de los trastornos mentales de sus hijos en una consulta universitaria en Colombia / Beliefs of parents of children with mental disorders in a university hospital out-patient clinic in Colombia

RESUMEN Objetivo: Describir las creencias de los padres acerca de los trastornos mentales de sus hijos que asistieron a consulta externa infantil en una clínica universitaria. Métodos: Estudio descriptivo transversal realizado en padres de niños con trastornos mentales de una clínica de cuarto nivel de Medellín, Colombia, durante el periodo comprendido entre enero y mayo del 2018. Se estudió a 98 padres de niños y adolescentes que consultaron por primera vez a Psiquiatría Infantil. Se aplicó un instrumento elaborado por los investigadores con variables demográficas y de creencias sobre: el origen del trastorno mental, del tratamiento y sus coadyuvantes. Resultados: El 49,9% de los 98 padres evaluados creyeron que su hijo tenía un trastorno mental; en cuanto al origen de este, el 43,9% creía que era heredado y 41,8% por causas orgánicas. El 95,9% de los padres creía que sus hijos necesitaban tratamiento, de ellos, el 90,4% estimó la psicoterapia y el 58,51%, la medicación. Entre los tratamientos alternativos el más frecuente fue la sanación, con un 27,5%. De los métodos coadyuvantes en el tratamiento, los más frecuentes fueron estimular comportamientos positivos con el 82,7%, y corregir con palabras y dar buen ejemplo con el 72,4%. Conclusiones: En este estudio casi la mitad de los padres pensaba que sus hijos tenían una enfermedad mental. El tratamiento más considerado por los participantes fue la psicoterapia, por encima del uso de psicofármacos. En cuanto a los métodos coadyuvantes, los padres consideraron principalmente el estimular comportamientos positivos, corregir con palabras y dar buen ejemplo.

ABSTRACT Objective: Describe the beliefs of parents about the mental disorders of their children who attended a paediatric outpatient clinic at a university hospital. Methods: This was a descriptive study with parents of children with mental disorders seen from January to May of 2018 at a high complexity hospital in Medellin, Colombia. Ninety-eight (98) parents of children and adolescents attending their first outpatient consultation with Paediatric Psychiatry were studied. An instrument designed by the investigators was applied to obtain demographic variables and beliefs about the origin of their child's mental disorder, treatment and adjuvants. Results: 49.9% of the 98 parents believed that their child had a mental disorder. 43.9% believed the disorder was inherited and 41.8% believed its cause was organic. 95.9% of the parents believed the child needed treatment, including psychotherapy (90.4%) and medication (58.51%). Among the alternative treatments the parents believed the child needed, healing was the most commonly cited by 27.5% of the parents. Of the adjuvant methods, the most commonly cited were reinforcing positive behaviour (82.7%) and correcting with words and setting a good example (72.4%). Conclusions: Nearly half of the parents believed their child had a mental disorder, the treatment that was most commonly considered was psychotherapy above medication, and the best adjuvant methods cited by parents were reinforcing positive behaviour, correcting with words and setting a good example.

Beliefs of parents of children with mental disorders in a university hospital out-patient clinic in Colombia. / Creencias de los padres acerca de los trastornos mentales de sus hijos en una consulta universitaria en Colombia.

OBJECTIVE: Describe the beliefs of parents about the mental disorders of their children who attended a paediatric outpatient clinic at a university hospital. METHODS: This was a descriptive study with parents of children with mental disorders seen from January to May of 2018 at a high complexity hospital in Medellin, Colombia. Ninety-eight (98) parents of children and adolescents attending their first outpatient consultation with Paediatric Psychiatry were studied. An instrument designed by the investigators was applied to obtain demographic variables and beliefs about the origin of their child's mental disorder, treatment and adjuvants. RESULTS: 49.9% of the 98 parents believed that their child had a mental disorder. 43.9% believed the disorder was inherited and 41.8% believed its cause was organic. 95.9% of the parents believed the child needed treatment, including psychotherapy (90.4%) and medication (58.51%). Among the alternative treatments the parents believed the child needed, healing was the most commonly cited by 27.5% of the parents. Of the adjuvant methods, the most commonly cited were reinforcing positive behaviour (82.7%) and correcting with words and setting a good example (72.4%). CONCLUSIONS: Nearly half of the parents believed their child had a mental disorder, the treatment that was most commonly considered was psychotherapy above medication, and the best adjuvant methods cited by parents were reinforcing positive behaviour, correcting with words and setting a good example.

Necesidades de cuidado y diagnósticos de enfermería en gestantes con depresión: estudio descriptivo / Care needs and nursing diagnoses of expectant mothers with depression: descriptive study / Necessidades de cuidado e diagnósticos de enfermagem em gestantes com depressão: estudo descritivo

Objetivo: describir las necesidades y los diagnósticos de enfermería en gestantes con depresión. Materiales y método: estudio descriptivo, retrospectivo, transversal. La muestra no probabilística a conveniencia, estuvo constituida por 55 gestantes con depresión, hos-pitalizadas entre enero 2013 a diciembre 2018. La información se recolectó a través de la aplicación de dos cuestionarios: el primero se construyó teniendo en cuenta los objetivos y la operacionalización de variables relacionadas con información demográfica, obstétrica y psiquiátrica ; el segundo con las necesidades de cuidado, tomadas del manual de valoración de M Gordon y sintomatología del DSM_5. Se extrajeron frecuencias absolutas y relativas para las variables cualitativas, mediana y RIC para la edad. Resultados: los diagnósticos de enfermería más frecuentemente formulados fueron los siguientes: deterioro de la regulación del estado de ánimo un 67,3%; riesgo de suicidio un 56,4%; desesperanza con un 52,7%; do-lor agudo un 50,9%; insomnio un 50,9%. Las necesidades de cuidado más frecuentes fueron: cambios en el estado de ánimo un 67.3%; conducta suicida un 56.4%; visión negativa de sí misma y del futuro un 52.7%; dolor un 50.9% e insomnio un 50.9%. Conclusiones: según los patrones alternados, las necesidades de cuidado y los diagnósticos, el componente de la salud más afectado en estas mujeres fue el mental; se encontró que estas pacientes tienen mayor frecuencia de consumo de drogas, menos adherencia al tratamiento psiquiátrico y más actitudes relacionadas con: conductas suicidas, desesperanza, visión negativa del futuro y el dolor, que en otros estudios en gestantes y en diagnósticos de enfermería con depresión.

Objective: Describe the needs and nursing diagnosis of expectant mothers with depression. Materials and method: Descriptive, retrospective, cross-sectional study. The convenience non-probabilistic sampling was made with 55 expectant mothers, hospitalized between Janu-ary 2013 and December 2018. The information was collected through the application of two questionnaires: the first was built considering the objectives and the operationalization of the variables related to the demographic, obstetrics, and psychiatric information; the second one with the care needs, taken from the M. Gordon's assessment guideline and symptomatology from DSM-5. Absolute and relative frequencies were extracted from the qualitative variables, median and IQR for age. Results: The most frequent nursing diagnoses were the following: deterioration of mood regulation 67.3%; suicide risk 56.4%; hopelessness 52.7%; acute pain 50.9%; insomnia 50.9%. The most frequent care needs were: mood swings 67.3%; suicidal behavior 56.4%; negative perspective of one-self and the future 52.7%; pain 50.9%. Conclu-sions: According to alteration patterns, care needs and the diagnoses, the mental component was the most affected health component for these women; it was found that the patients have a high tendency of drug consumption, unwillingness to take the psychiatric treatment and more attitudes related to: suicidal behavior, hopelessness, a negative perspective of the fu-ture, and pain, showing that depression is highly present in expectant mothers.

Objetivo: descrever as necessidades e os diagnósticos de enfermagem em gestantes com de-pressão. Materiais e métodos: estudo descritivo, retrospectivo, transversal. A amostra não probabilística a conveniência esteve formada por 55 mulheres grávidas com depressão, in-ternadas entre janeiro de 2013 e dezembro de 2018. A informação coletou-se através da apli-cação de dois formulários: o primeiro, construiu-se considerando os objetivos e a operacion-alização das variáveis relacionadas com a informação demográfica, obstétrica e psiquiátrica; o segundo com as necessidades de cuidado, tomadas do manual de valoração de M Gordon e sintomatologia do DSM-5. Obtiveram-se frequências absolutas e relativas para as variáveis qualitativas, mediana e RIQ para a idade. Resultados: os diagnósticos de enfermagem mais frequentemente formulados foram: deterioro da regulação do estado de animo (67,3%); risco de suicídio (56,4%); desesperança (52,7%); dor aguda (50,9%) e insônia (50,9%). As neces-sidades de cuidado mais frequentes foram: mudanças no estado de animo (67,3%); conduta suicida (56,4%); visão negativa de si mesmo e do futuro (52,7%) e insônia (50.9%) Con-clusões: segundo os padrões de alteração, as necessidades de cuidado e os diagnósticos , o componente de saúde mais afetado nessas mulheres foi o mental, encontrando-se que essas pacientes têm uma grande tendência ao consumo de drogas, menos disposição ao tratamento psiquiátrico e mais atitudes relacionadas com condutas suicidas, desesperança, visão nega-tiva do futuro e dor, observando-se que nessas mulheres grávidas está presente a depressão.

Características demográficas, de salud, necesidades de cuidado y diagnósticos de enfermería de personas hospitalizadas que sufren trastorno afectivo bipolar / Demographic and Health Characteristics, Care Needs and Nursing Diagnoses in Hospitalized Individuals with Bipolar Affective Disorder / Características demográficas, de saúde, necessidades de cuidado e diagnósticos de enfermagem de pessoal hospitalizado sofrendo transtorno afetivo bipolar

Introducción: el trastorno afectivo bipolar (TAB) es una enfermedad mental crónica más frecuente en mujeres que en hombres. La prevalencia en el mundo es del 1% y en Colombia es del 1,2%. Objetivo: Describir las características demográficas, de salud, necesidades de cuidado y diagnóstico de enfermería en pacientes que ingresan a hospitalización con un diagnóstico de TAB a la Clínica Psiquiátrica Nuestra Señora del Sagrado Corazón. Método: Estudio descriptivo retrospectivo. Se seleccionaron 158 historias clínicas entre enero y junio de 2015, La información se recolectó de las notas de ingreso del equipo terapéutico, y para las necesidades de cuidado se utilizaron los patrones funcionales de Marjory Gordon. Resultados: el 55,7% eran mujeres, con edades entre 19 y 82 años, el 71,5% eran residentes de Medellin, el 47,5% eran solteros, el 19% tenían estudios secundarios. El 66,5% presentó sintomatologia propia del TAB en el momento del ingreso; el diagnóstico CIE-10 más frecuente fue TAB-episodio maniaco, presente con síntomas psicóticos. Las necesidades encontradas, según los patrones de Marjory Gordon, fueron: falta de introspección, presencia de insomnio, alucinaciones y autoagresión. Para estas necesidades los diagnósticos de enfermería fueron: deterioro de la toma de decisiones independiente, trastorno del patrón del sueño y riesgo de violencia autodirigida. Conclusiones: La información demográfica y de salud es similar a las características reportadas por otras investigaciones. Tanto las necesidades de cuidado y los diagnósticos de enfermería son congruentes con la incapacidad mental que impiden un adecuado autocuidado.

Introduction: Bipolar Affective Disorder (BAD) is a chronic mental illness more frequently found in woman than in men. The prevalence over the world is 1% and in Colombia is 1.2%. Objective: To describe the demographic and health characteristics, care needs and nursing diagnoses in patients hospitalized due to a BAD diagnosis in the mental-health clinic Clínica Psiquiátrica Nuestra Señora del Sagrado Corazón. Method: This is a retrospective descriptive study. One hundred and fifty-eight medical records were selected between January and June 2015. Information was gathered from the admission notes by the therapeutic team; the functional patterns by Marjory Gordon were used to examine the care needs based on the data. Results: In the sample, 55.7%were women from 19 to 82 years old; 71.5% of the sample lived in Medellin; 47.5% were single individuals; 19% had completed the high school. A 66.5% showed symptoms typical to the BAD at the time of admission; under the CIE-10 diagnosis, the BAD maniac episode was the most frequent and included psychotic symptoms. According to the patterns by Marjory Gordon, the nursing needs found in the sample were: lack of introspection, sleeplessness, hallucinations, and selfharming. Regarding these needs, the nursing diagnoses were: deterioration in the independent decision-making; disorder of the sleep pattern and self-harming risk. Conclusions: The demographic and health information is similar to the typical characteristics reported in other researches. Both the care needs and nursing diagnoses are consistent with the mental inability, which hampers an appropriate self-care.

Introdução: O transtorno afetivo bipolar (TAB) é uma doença mental crônica mais frequente em mulheres do que em homens. A prevalência no mundo é de 1 % e na Colômbia é de 1,2%. Objetivo: Descrever as características demográficas, de saúde, necessidades de cuidado e diagnóstico de enfermagem em pacientes internos com diagnóstico de TAB na Clínica Psiquiátrica Nuestra Señora del Sagrado Corazón. Método: Estudo descritivo retrospectivo. Selecionaram-se 158 relatórios clínicos entre janeiro e junho de 2015. A informação foi coletada das anotações de admissão da equipe terapêutica, e para as necessidades de cuidado foram utilizados padrões funcionais de Marjory Gordon. Resultados: 55,7% foram mulheres, com idades entre 19 e 82 anos, 71,5% foram residentes em Medellin, 47,5% solteiros, 19% tinham ensino médio. 66,5% apresentou sintomatologia própria do TAB no momento do ingresso; o diagnóstico CIE-10 mais frequente foi TAB-episódio maníaco, presente com sintomas psicóticos. As necessidades encontradas, de acordo com os padrões de Marjory Gordon, foram: falta de introspeção, presença de insônia, alucinações e autoagressão. Para tais necessidades os diagnósticos de enfermagem foram: deterioração da tomada de decisões independente, transtorno do padrão de sonho e risco de violência autodirigida. Conclusões: As informações demográficas e de saúde são semelhantes às caraterísticas relatadas por outras pesquisas. Tanto as necessidades de cuidado quanto os diagnósticos de enfermagem são congruentes com a incapacidade mental que impede um adequado autocuidado.

Delirium during the first evaluation of children aged five to 14 years admitted to a paediatric critical care unit.

OBJECTIVES: To describe the prevalence and characteristics of delirium during the initial evaluation of critically ill patients aged 5-14 years. METHOD/DESIGN: This is a cross-sectional descriptive study in a critical care unit. For six months, all patients were evaluated within the first 24-72 hours or when sedation permitted the use of the paediatric confusion assessment method for the intensive care unit (PCAM-ICU) and the Delirium Rating Scale-Revised-98 items #7 and #8 to determine motor type. We report the characteristics of PCAM-ICU delirium (at least three of the required items scored positive) and of subthreshold score cases (two positive items). RESULTS: Of 77 admissions, 15 (19.5%) had delirium, and 11 (14.2%) were subthreshold. A total of 53.3% of delirium and 45.5% of subthreshold cases were hypoactive. The prevalence of delirium and subthreshold PCAM-ICU was 83.3% and 16.7% in mechanically ventilated children. The most frequent combination of PCAM-ICU alterations in subthreshold cases was acute onset-fluctuation with altered alertness. The main nursing diagnoses were related to reduced cellular respiration. CONCLUSIONS: Delirium is common in critically ill children. It is necessary to assess whether certain nursing diagnoses imply an increase in delirium. Longitudinal studies of subthreshold PCAM-ICU cases are needed to understand their importance better.

Características sociales de salud en urgencias de la Clínica Universitaria Bolivariana (Medellín-Colombia) por intoxicación con sustancias psicoactivas

Introducción: El consumo crónico de sustancias psicoactivas ocasiona daños en la salud física, los cuales algunas veces pueden ser graves y ameritan consulta a los servicios de urgencias. Materiales y métodos: Estudio descriptivo retrospectivo que puntualizó las características sociodemográficas y de salud, de las personas que consultaron a urgencias de la Clínica Universitaria Bolivariana (Medellín - Colombia), intoxicadas por sustancias psicoactivas. La muestra a conveniencia estuvo constituida por 100 historias clínicas. Resultados: En el análisis de las historias clínicas consultadas, se encontró lo siguiente: los hombres fueron quienes más consultaron; la sustancia con mayor consumo fue el alcohol; el día con más consulta fue el domingo. Se administraron básicamente, líquidos venosos y analgésicos. Conclusiones: La intoxicación alcohólica fue la más usual; los antecedentes personales más frecuentes fueron psiquiátricos; los síntomas principales: deshidratación y molestias gastrointestinales.

Introduction: The chronic use of psychoactive substances causing harm to the physical health which sometimes can be severe and merits inquiry the emergency services. Methods: Retrospective descriptive study that described the sociodemographic and health of people who consulted urgency intoxicated by psychoactive substance characteristics. The convenience sample and consisted of 100 medical records. Results: The analysis found that those most consulted were men, the most consumed substance was alcohol followed by two or more substances, the day was over on Sunday. Most drugs were administered, the venous fluids and painkillers. Conclusions: Alcohol intoxication was the most common, the most common psychiatric medical history were the most frequent symptoms were dehydration and gastrointestinal upset.

Introdução: O consumo crónico de substâncias psicoactivas provoca danos à sua saúde física que às vezes pode ser grave e merece inquérito alos de emergência serviços. Materiais e métodos: Estudo descritivo retrospectivo que descreveu as características sócio-demográficas e saúde das pessoas que olhavam emergência intoxicada por substâncias psicoativas. Amostra de conveniência e consistiu de 100 registros. Resultados: A análise descobriu que pessoas que olhou a maioria eram homens, a substância mais consumida era álcool seguido de duas ou mais substâncias, o dia que foi no domingo. O que eram a maioria dos medicamentos administrados, fluidos venosos e analgésicos. Conclusões: Alcool intoxicação foi a mais frequente frequente história pessoal psiquiátrico, os sintomas mais frequentes foram a desidratação e gastrointestinal chateado de palavras-chave: intoxicação, drogas psicotrópicas, saúde, perfil de condições sociais.

[Sociodemographic characteristics and mental disorders in children and adolescents psychiatric outpatient clinic children of Medellin]. / Características sociodemográficas y trastornos mentales en niños y adolescentes de consulta externa psiquiátrica infantil de una clínica de Medellín.

INTRODUCTION: Mental disorders in the world affecting 15% to 30% in children and adolescents, altering its function and emotional, cognitive and social. Affect interpersonal relationships, school performance and increased substance use and the risk of suicide. OBJECTIVE: describe the social-demographic characteristics and mental disorders of children and adolescents of psychiatric consultation. METHOD: Retrospective descriptive study that analyzed all the histories of children and adolescents of both sexes from 5 to 16 years who attended for the first time outpatient psychiatry university clinic of Medellin, from July 2010 to July 2012. RESULTS: We studied 197 patients, the average age was 11±3.5 years, male sex was the most common 69%, 46.2% belonged to nuclear family. The most prevalent psychiatric disorders were 44.2% ADHD, depressive disorders 9.1% and 8.1% TOC. 61% had psychiatric comorbidity, the most frequent was oppositional defiant disorder with ADHD 35.6%. CONCLUSIONS: The frequency of mental disorders and comorbidities found in this study were similar to those reported by other researchers.

Prevalencia de tamizaje positivo para depresión y ansiedad en gestantes de alto riesgo obstétrico en una clínica de Medellín, entre enero y agosto de 2013. Factores de riesgo asociados / Prevalence of positive screening for depression and anxiety in high obstetric risk pregnant women in a clinic in Medellin, between January and August 2013, and associated risk factors

Determinar la prevalencia de tamizaje positivo para depresión y ansiedad, y los factores de riesgo asociados.Materiales y métodos: estudio transversal, en gestantes con alto riesgo obstétrico, atendidas en un centro de referencia en Medellín (Colombia), entre enero y agosto del 2013. Se utilizaron los inventarios de Depresión de Beck versión II (BDI-II) con punto de corte de 12, y el de Ansiedad de Beck con punto de corte de 16. Se analizaron variables demográficas, reproductivas, culturales, patologías asociadas al embarazo y antecedentes psiquiátricos y de violencia. Se evaluó el OR y su respectivo intervalo de confianza del 95 %. Se presenta la prevalencia del periodo.Resultados: se incluyó un total de 189 gestantes; la prevalencia de tamizaje positivo para depresión fue de 61,4 % y para ansiedad fue de 40,7 %. Se encontró asociación entre el tamizaje positivo de depresión con los antecedentes de la misma (OR = 7,1; IC 95 %: 2,6-19,2); el maltrato psicológico (OR = 8,7; IC 95 %: 2-38,5); tener pareja disfuncional (OR = 5,1; IC 95 %: 1,9-13,8), y tener hijos menores de cinco años (OR = 4,9; IC 95 %: 1,8-13,4). Respecto al tamizaje positivo para ansiedad se encontró asociación con haber sido víctima de situaciones sociales adversas (OR = 1,85; IC 95 %; 1,03-3,34) o haber vivido un desastre natural (OR = 2,11; IC 95 %: 1,0-4,5).Conclusiones: la prevalencia de tamizaje positivo para depresión y ansiedad es alta en las gestantes con embarazos de alto riesgo, dichos síntomas deben ser explorados en estas pacientes...

To determine the prevalence of positive screening for depression and anxiety, and associated risk factors.Materials and methods: Cross-sectional study of high obstetric risk pregnant women seen at a referral centre in Medellín, Colombia, between January and August 2013. The Beck Depression inventory version II (BDI-II) was used with a cut-off point of 12, and the Beck Anxiety inventory was used with a cut-off point of 16. Demographic, reproductive, and cultural variables were analysed as well as pregnancy-associated disorders, a history of psychiatric disorders or a history of violence. Odds ratio and its 95% confidence interval were estimated. The prevalence for the period is presented.Results: A total of 189 pregnant women were included. The prevalence of positive screening for depression and anxiety was 61.4% and 40.7%, respectively. An association was found between positive depression screening and a histor y of depression (OR = 7.1; 95% CI: 2.6:19.2); psychological abuse (OR = 8.7; 95% CI: 2-38.5); having a dysfunctional partner (OR = 5.1; 95% CI: 1.9-13.8); and having children under 5 years of age (OR = 4.9; 95% CI: 1.8-13.4). A statistical risk association was found between positive anxiety screening and having been a victim of adverse social circumstances (OR = 1.85; 95% CI: 1.03-3.34) or having survived a natural disaster (OR = 2.11; 95% CI: 1-4.5).Conclusions: The prevalence of positive screening for depression and anxiety is high among women with high-risk pregnancy. These symptoms must be explored in these patients...

Características sociodemográficas y trastornos mentales en niños y adolescentes de consulta externa psiquiátrica infantil de una clínica de Medellín / Sociodemographic characteristics and mental disorders in children and adolescents psychiatric outpatient clinic children of Medellin

Introducción: Los trastornos mentales en el mundo afectan a un 15-30% de los niños y adolescentes, lo que compromete el funcionamiento y el desarrollo emocional, cognitivo y social, afectan a las relaciones interpersonales y el rendimiento escolar y aumentan el riesgo de consumo de sustancias y de suicidio. Objetivo: Describir las características sociodemográficas y los trastornos mentales de niños y adolescentes de consulta psiquiátrica. Método: Estudio descriptivo retrospectivo que analizó la totalidad de las historias clínicas de niños y adolescentes de ambos sexos de 5-16 años que asistieron por primera vez a consulta externa de psiquiatría en una clínica universitaria de Medellín, desde julio de 2010 a julio de 2012. Resultados: Se estudió a 197 pacientes; la media de edad era 11±3,5 años; el sexo más frecuente fue el masculino (69%); el 46,2% pertenecía a familia nuclear. Los trastornos psiquiátricos más prevalentes fueron el déficit de atención e hiperactividad (44,2%), los depresivos (9,1%) y el obsesivo-compulsivo (8,1%). Un 61% tenía comorbilidad psiquiátrica; la más frecuente fue el trastorno oposicional desafiante con déficit de atención e hiperactividad (35,6%). Conclusiones: La frecuencia de trastornos mentales y comorbilidades encontradas en este estudio es similar a la reportada por otros investigadores.

Introduction: Mental disorders in the world affecting 15% to 30% in children and adolescents, altering its function and emotional, cognitive and social. Affect interpersonal relationships, school performance and increased substance use and the risk of suicide. Objective: describe the social-demographic characteristics and mental disorders of children and adolescents of psychiatric consultation. Method: Retrospective descriptive study that analyzed all the histories of children and adolescents of both sexes from5 to 16 yearswhoattended for the first time outpatient psychiatry university clinic of Medellin, from July 2010 to July 2012. Results: We studied 197 patients, the average age was 11±3.5 years, male sex was the most common 69%, 46.2% belonged to nuclear family. The most prevalent psychiatric disorders were 44.2%ADHD, depressive disorders 9.1% and 8.1% TOC. 61% had psychiatric comorbidity, the most frequent was oppositional defiant disorder with ADHD 35.6%. Conclusions: The frequency of mental disorders and comorbidities found in this study were similar to those reported by other researchers.

Social, health and consumption profiles and perceptions of treatment in a group recovering alcoholics, Medellín, Colombia / Perfil social, de salud, de consumo y percepción del tratamiento de un grupo de alcohólicos en proceso de recuperación, Medellín, Colombia

Alcohol is responsible for 2.5 million deaths annually and is a risk factor in certain communicable diseases. The negative of its consumption can be felt in all areas of life. The object of this descriptive study was to determine the social, health and consumption characteristics and the perceptions of rehabilitation treatment in alcoholics. The information was collected using a questionnaire for the social and health variables and a semi-structured interview to determine perceptions of treatment. The majority were male, middle class and had begun consuming alcohol at 11 years of age, with depression being the most common psychological comorbidity. They perceived treatment as welfare.

O álcool causa 2,5 milhões de mortes anualmente, é fator de risco para quem sofre alguma enfermidade transmissível, seu consumo traz consequências negativas em todos os âmbitos. O objetivo deste estudo descritivo foi determinar as características sociais, de saúde, de consumo e a percepção sobre o tratamento de reabilitação em pessoas alcoólicas. A informação foi coletada através de um questionário para conhecer variáveis sociais e de saúde, e uma entrevista semiestruturada para determinar a percepção do tratamento. O perfil da maioria das pessoas era homens de classe média que começaram a consumir aos 11 anos de idade e que apresentavam a depressão como comorbidade psiquiátrica mais frequente. Viam o tratamento como uma questão de bem-estar.

El alcohol causa anualmente 2.5 millones de muertes, es factor de riesgo para sufrir alguna enfermedad trasmisible, su consumo trae consecuencias negativas en todos los ámbitos. En este estudio descriptivo, el objetivo fue determinar las características sociales, de salud, de consumo y la percepción sobre el tratamiento de rehabilitación en personas alcohólicas. La información se recolecto a través de una encuesta para conocer variables sociales y de salud y una entrevista semiestructurada para determinar la percepción del tratamiento. La mayoría de las personas fueron hombres, de clase media que iniciaron el consumo a los 11 años de edad y cuya comorbilidad psiquiátrica más frecuente fue la depresión. Percibían el tratamiento como un bienestar.

Social, health and consumption profiles and perceptions of treatment in a group recovering alcoholics, Medellín, Colombia / Perfil social, de saúde, de consumo e percepção do tratamento de um grupo de alcoólicos em processo de recuperação, Medellín, Colombia / Perfil social, de salud, de consumo y percepción del tratamiento de un grupo de alcohólicos en proceso de recuperación, Medellín, Colombia

Alcohol is responsible for 2.5 million deaths annually and is a risk factor in certain communicable diseases. The negative of its consumption can be felt in all areas of life. The object of this descriptive study was to determine the social, health and consumption characteristics and the perceptions of rehabilitation treatment in alcoholics. The information was collected using a questionnaire for the social and health variables and a semi-structured interview to determine perceptions of treatment. The majority were male, middle class and had begun consuming alcohol at 11 years of age, with depression being the most common psychological comorbidity. They perceived treatment as welfare.(AU)

O álcool causa 2,5 milhões de mortes anualmente, é fator de risco para quem sofre alguma enfermidade transmissível, seu consumo traz consequências negativas em todos os âmbitos. O objetivo deste estudo descritivo foi determinar as características sociais, de saúde, de consumo e a percepção sobre o tratamento de reabilitação em pessoas alcoólicas. A informação foi coletada através de um questionário para conhecer variáveis sociais e de saúde, e uma entrevista semiestruturada para determinar a percepção do tratamento. O perfil da maioria das pessoas era homens de classe média que começaram a consumir aos 11 anos de idade e que apresentavam a depressão como comorbidade psiquiátrica mais frequente. Viam o tratamento como uma questão de bem-estar.(AU)

El alcohol causa anualmente 2.5 millones de muertes, es factor de riesgo para sufrir alguna enfermedad trasmisible, su consumo trae consecuencias negativas en todos los ámbitos. En este estudio descriptivo, el objetivo fue determinar las características sociales, de salud, de consumo y la percepción sobre el tratamiento de rehabilitación en personas alcohólicas. La información se recolecto a través de una encuesta para conocer variables sociales y de salud y una entrevista semiestructurada para determinar la percepción del tratamiento. La mayoría de las personas fueron hombres, de clase media que iniciaron el consumo a los 11 años de edad y cuya comorbilidad psiquiátrica más frecuente fue la depresión. Percibían el tratamiento como un bienestar.(AU)

Validez y utilidad diagnóstica de la escala EAT-26 para la evaluación del riesgo de trastornos de la conducta alimentaria en población femenina de Medellín, Colombia / Diagnostic validity and usefulness of the Eating Attitudes Test-26 for the assessment of eating disorders risk in a Colombian female population

OBJETIVO: Evaluar la validez y la utilidad diagnóstica de la escala EAT-26 para la evaluación del riesgo de trastornos de conducta alimentaria (TCA) en población femenina. DISEÑO: Estudio observacional de validación de pruebas. Emplazamiento: Realizado en la ciudad de Medellín en nivel de atención comunitaria de consulta psiquiátrica mixta (pública y privada). Participantes: Veinticinco mujeres con edades entre 15 y 25 años que cumplieran criterios DSM-IV-TR para anorexia y bulimia nerviosa y 111 controles sin TCA. Mediciones principales: La muestra de casos fue por conveniencia y en controles, aleatoria simple. Se comparó el «criterio de oro» (entrevista estructurada por psiquiatra para determinar el cumplimiento o no de criterios de inclusión de caso de TCA) con el EAT-26, y al instrumento se le hizo validación cultural y semántica, validación factorial, evaluación de confiabilidad, así como determinación del mejor punto de corte por medio de la curva ROC. RESULTADOS: En EAT-26 subyacen 4 dominios: bulimia, dieta, preocupación por la comida y control oral. El alfa de Cronbach fue de 92,1%, y el mejor valor de corte, el de 11 y más puntos (sensibilidad del 100% y especificidad del 85,6%). CONCLUSIÓN: El EAT-26 modificado y abreviado es un instrumento multidimensional, con excelentes valores de confiabilidad y sensibilidad, y con un adecuado valor de especificidad, apropiado para el cribado de posible TCA en población de riesgo y útil en atención primaria para su detección temprana en mujeres jóvenes

OBJECTIVE: To establish diagnostic validity and usefulness of EAT-26 for the risk assessment of Eating Disorder (ED) in a female population. Description: Observational validation study questionnaire. Setting: Performed in a Medellin city community care level of mixed (public and private)psychiatric consultation. Subjects: Twenty five subjects aged 15 to 25 with DSM-IV-TR diagnostic criteria for anorexia and bulimia nervosa and 111 controls without ED. Main outcomes measures: The case sample was for convenience and in controls an aleatory simple one. Gold standard (structured psychiatrist interview confirming the fulfillment of ED case inclusion criteria) was compared with EAT-26 questionnaire; reliability was assessed, cultural, semantics and factorial validation was made and the best cut-off score was established with the ROC curve. RESULTS: Four domains remain in the instrument: bulimia, dieting, food preoccupation and oral control. The Cronbach's alpha was 92.1% and a score of 11 and over is the best cut-off (sensitivity100%, and specificity 85.6%). CONCLUSIONS: This modified and abbreviated EAT-26 questionnaire is an ideal multidimensional instrument for ED screening in risk population, with excellent reliability and sensitivity values and satisfactory specificity. EAT-26 is a useful measure to be considered when strategies for ED early detection are implemented in young women

[Diagnostic validity and usefulness of the Eating Attitudes Test-26 for the assessment of eating disorders risk in a Colombian female population]. / Validez y utilidad diagnóstica de la escala EAT-26 para la evaluación del riesgo de trastornos de la conducta alimentaria en población femenina de Medellín, Colombia.

OBJECTIVE: To establish diagnostic validity and usefulness of EAT-26 for the risk assessment of Eating Disorder (ED) in a female population. DESCRIPTION: Observational validation study questionnaire. SETTING: Performed in a Medellin city community care level of mixed (public and private) psychiatric consultation. SUBJECTS: Twenty five subjects aged 15 to 25 with DSM-IV-TR diagnostic criteria for anorexia and bulimia nervosa and 111 controls without ED. MAIN OUTCOMES MEASURES: The case sample was for convenience and in controls an aleatory simple one. Gold standard (structured psychiatrist interview confirming the fulfillment of ED case inclusion criteria) was compared with EAT-26 questionnaire; reliability was assessed, cultural, semantics and factorial validation was made and the best cut-off score was established with the ROC curve. RESULTS: Four domains remain in the instrument: bulimia, dieting, food preoccupation and oral control. The Cronbach's alpha was 92.1% and a score of 11 and over is the best cut-off (sensitivity 100%, and specificity 85.6%). CONCLUSIONS: This modified and abbreviated EAT-26 questionnaire is an ideal multidimensional instrument for ED screening in risk population, with excellent reliability and sensitivity values and satisfactory specificity. EAT-26 is a useful measure to be considered when strategies for ED early detection are implemented in young women.

Calidad de vida de pacientes con dependencia a heroína de un centro de atención de drogodependencias de Medellín (Colombia) / Qualidade de vida de pacientes com dependência a heroína de um centro de atendimento de drogo-dependências de Medellín (Colômbia) / Quality of life of heroin dependent patients from a drug dependence attention center of Medellin (Colombia)

Objetivo. Describir la calidad de vida en términos de salud adictos a heroina atendidos en diferentes fases de tratamiento de pacientes en un centro de drogodependencias de la ciudad de Medellín. Metodología. Estudio epidemiológico de tipo transversal. Se encuestaron, en 2009, a 40 adictos a heroína en las diferentes etapas de tratamiento: deshabituación, reinserción social y programa de mantenimiento con metadona. Se aplicó el instrumento para evaluación de la calidad de vida SF-36 y el Test de Zung para depresión. Se realizó análisis descriptivo y comparaciones a través de pruebas no paramétricas para determinar diferencias entre los grupos (grupo 1: pacientes hospitalizados, en fase de deshabituación y reinserción social, y grupo 2: pacientes en cualquiera de las fases del programa de mantenimiento con metadona con la fase de tratamiento). Se asumió significancia estadística si la p< 0.05 para determinar diferencias entre los grupos. Resultados. Participaron 40 pacientes (19 en el grupo 1 y 21 en el grupo 2). Se encontró que la calidad de vida fue mejor para el grupo 2, con diferencias estadísticamente significativas para todos los dominios excepto para función física y salud mental, las cuales desde el inicio tenían puntajes superiores al percentil 75. Conclusión. La calidad de vida es mejor en los pacientes que llevan más tiempo en el programa de mantenimiento con metadona.

Objective. To describe the quality of life in terms of health, in the different stages of treatment of patients addict to heroin attended in a drug-dependence attention center of Medellin. Methodology.Cross sectional epidemiological study. 40 heroin addicts in the different stages of treatment: dishabituation, social reinsertion and maintenance program with methadone were interviewed in 2009. The SF-36 instrument for the evaluation of the quality of life and the Zung’s test for depression were used. Descriptive analysis and comparisons through non parametric tests to determine differences among the groups were performed (Group 1: Hospitalized patients, in phase of dishabituation and social reinsertion, and group 2: patients in any of the stages of the methadone’s maintenance program according to the treatment’s phase). Statistical significance was assumed if p<0.05 to determine differences among groups. Results. 40 patients participated (19 in group 1 and 21 in group 2). It was found that the quality of life was better in the patients in group 2 with statistical significant differences for all the domains, except for the physical function and mental health, which from the beginning had higher scores than the 75th percentile. Conclusion. Quality of life is better in patients who have longer time in the maintenance program with methadone.

Objetivo. Descrever a qualidade de vida em termos de saúde nas diferentes fases de tratamento de pacientes adictos a heroína atendidos num centro de drogo-dependências de Medellín. Metodologia. Estudo epidemiológico de tipo transversal. A enquete feita em 2009 a 40 adictos a heroína nas diferentes etapas de tratamento: perder o hábito, reinserção social e programa de manutenção com metadona. Aplicou-se o instrumento para avaliação da qualidade de vida SF-36 e o Teste de Zung para depressão. Realizou-se análise descritiva e comparações através de provas não paramétricas para determinar diferenças entre os grupos (grupo 1: pacientes hospitalizados, em fase de perder o hábito e reinserção social e grupo 2: pacientes em qualquer das fases do programa de manutenção com metadona de acordo à fase de tratamento). Assumiu-se significância estatística se o p< 0.05 para determinar diferenças entre os grupos. Resultados. Participaram 40 pacientes (19 no grupo 1 e 21 no grupo 2). Encontrou-se que a qualidade de vida dos pacientes foi melhor para o grupo 2, com diferenças estatisticamente significativas para todos os domínios exceto para função física e saúde mental, as quais desde o início tinham pontuação superiores ao percentil 75. Conclusão. A qualidade de vida é melhor nos pacientes que levam mais tempo no programa de manutenção com metadona.

Características sociodemográficas y trastornos mentales en niños y adolescentes habitantes de la calle en un centro de atención social de Medellín, Colombia / Sociodemographic caracteristics and mental disorders in homeless child and adolescents in shelter Medellin, Colombia

Objetivo: describir las características demográficas y la prevalencia de algunos trastornos mentales en niños y adolescentes habitantes de calle que asistían al Centro de Acogida de Medellín (Colombia). Metodología: estudio descriptivo transversal en una muestra de 148 niños y adolescentes en quienes se valoró aspectos sociodemográficos y se determinó la prevalencia de algunos trastornos mentales a través de entrevista estructurada específica para este grupo de edad (MINI KID). Resultados: la edad promedio fue de 14.8 años y el 85.1% estaba conformado por hombres. El motivo más frecuente para estar en la calle fue el maltrato familiar (43.2%). El 50% llevaba al menos 24 meses habitando en la calle. El 85.8% presentó alguno de los trastornos mentales evaluados, el más prevalente fue la dependencia de drogas (58.1%), seguido por el trastorno de conducta (54%) y el negativista desafiante con el 49.3%. Conclusiones: la prevalencia de trastornos mentales en los niños y adolescentes habitantes de la calle fue similar a la reportada en otros países en esta misma población. Se encontró que el más prevalente fue la dependencia de drogas y la causa principal de vivir en la calle fue el maltrato.

Percepciones sociales frente a la comunicación del tratamiento y apoyo recibido por la población habitante de calle con tuberculosis / Social perceptions regarding treatment communication and received support for homeless population with tuberculosis

Objetivo: Estudio cualitativo fenomenológico, realizado con el objetivo de conocer las percepciones sociales acerca de la comunicación del tratamiento, del apoyo social y familiar de un grupo de habitantes de calle con diagnóstico de Tuberculosis, quienes estuvieron en tratamiento en un centro de asistencia social. Método: La muestra se definió por conveniencia y estuvo conformada por 23 personas a las que se les realizó una entrevista semiestructurada a partir de la que se construyeron las categorías de análisis: percepciones sociales en relación con la comunicación del tratamiento, con el apoyo social y familiar y de acuerdo con perfiles por sexo, edad y diagnóstico previo de Tuberculosis. Resultados: En este análisis se encontró que la comunicación del diagnóstico es incompleta y que existen diversas creencias alrededor de la Tuberculosis que configuran una representación social que da sentido a la enfermedad y a su tratamiento, pero que no es apropiada para garantizar el éxito del mismo. Las percepciones sociales relacionadas con el apoyo social y familiar señalan que estas instituciones son muy significativas para la restauración de vínculos familiares y sociales para lograr una adecuada adherencia al tratamiento. Conclusiones: Una acertada y eficaz comunicación, además del trabajo interdisciplinario, son imprescindibles para lograr éxito en el tratamiento de esta enfermedad.

Objective: The following is phenomenological and qualitative study developed with the objective of getting to know the social perceptions regarding treatment communication, and social and family support of a group of homeless people with diagnosisof Tuberculosis who received treatment on a social assistance center. Methods: The study sample was defined by convenience and was represented by 23 people who received the application ofa semistructured interview from which analysis categories were constructed regarding treatment communication, social and family support according to profiles such as gender, age, and previous diagnosis of tuberculosis.Results: Upon analysis it was found that diagnosis communication is incomplete y that a lot of beliefs are held regardingTuberculosis, which configures a social representation that grants sense to the disease and its treatment, although failing to guarantee the success of the latter. Social perceptions related to social and family support point out that these institutions are important on restoring social and family links important for an adequate adherence to treatment. Conclusion: Good communication and interdisciplinary team work are important upon succeeding the treatment on thisdisease.

Consumo de alcohol y tabaco en estudiantes de pregrado de una universidad privada de Medellín, 2007 / Alcohol and tobacco use by university undergraduate students of Medellín, 2007

Objetivo: identificar las características demográficas del consumo de alcohol y tabaco en estudiantes de pregrado de una universidad de Medellín, Colombia, durante el primer periodo académico de 2007. Metodología: es un estudio descriptivo transversal. Se tomó una muestra representativa de 1406 estudiantes de pregrado. El instrumento para recolectar la información fue un cuestionario autoaplicado. Resultados: el estudio encuestó a 1406 estudiantes, con un promedio de edad de 20,8 años. El 51,2% de los encuestados fueron mujeres y el estado civil predominante fue el de soltero (97,6%). Se encontraron prevalencias anuales de 94,0% y 42,4%, para alcohol y tabaco respectivamente. El riesgo de alcoholismo, según el test de CAGE fue del 8%, mientras que el riesgo de dependencia a la nicotina, según el test de Fagerstrõm, fue del 6%. El sexo masculino y el grupo de 16 a 24 años tuvieron las mayores prevalencias de consumo de estas sustancias y las mayores proporciones de dependencia a la nicotina o de alto riesgo de alcoholismo. Conclusión: el consumo de alcohol y/o tabaco en estudiantes es un problema que merece atención de los organismos encargados de los programas de bienestar universitario.

Objective: to identify the demographic, as well as the tobacco and alcohol use characteristics of undergraduate students from a Medellín, Colombia, well-known university during the first 2007 academic period. Methodology: a transversal descriptive study was carried of a representative population of 1.406 undergraduate students from the said educative institution. The study instrument was an auto-applied questionnaire. Results: during the study period 1.406 students were interviewed, with an average age of 20,8 years. Other general characteristics of the population were: 51,2% of the interviewed people was female and the predominant marital status was single (97,6%). Annual prevalence of 94,0% and 42,4% for alcohol and tobacco use were found, respectively. Alcoholism risk, according to the CAGE test, was 8%, while nicotine dependence risk was 6% according to the Fagerstrõm test. Males and the 16-24 ages group have the highest substance use prevalence and the highest alcoholism and/or nicotine dependence risk. Conclusion: alcohol and tobacco use in this studied university is a problem deserving attention from health care offices.

Características de las personas adictas a la heroína en tratamiento en una empresa social del estado de enero de 2003 a junio de 2008 / Características de pessoas viciadas em heroína sob tratamento em uma empresa social pública entre janeiro de 2003 e junho de 2008 / Characteristics of heroin addicts in treatment in a public social company, from january 2003 till june 2008

Se realizó un estudio descriptivo, para identificar características sociales, de salud y de consumo de heroinómanos en tratamiento en CARISMA, entre enero del 2003 a junio del 2008. La información se obtuvo de las historias clínicas. La edad promedio fue de 22.6, el 74 por ciento eran hombres; el 39.7 por ciento pertenecían a familias monoparentales, el 47.9 por ciento eran de estrato bajo, el 50.7 por ciento cursaban educación superior. Las comorbilidades fueron la depresión y trastornos de personalidad con 32.9 por ciento; la vía más frecuente fue la venosa con 74 por ciento; el promedio de consumo fue 4 veces al día; otros consumos fueron marihuana 80.8 por ciento; benzodiazepinas 54.8 por ciento.

Foi realizado um estudo descritivo para identificar características sociais, de saúde e de consumo de viciados em heroína sob tratamento em CARISMA, entre janeiro de 2003 e junho de 2008. A informação foi coletada das histórias clínicas. A idade média foi 22.6, 74 por cento eram homens; 39.7 por cento pertence a famílias de mono-parentais, 47.9 por cento era de classe social baixa, 50.7 por cento cursava educação superior. As co-morbidades foram depressão e transtornos de personalidade com 32.9 por cento; a via mais freqüente foi a venosa com 74 por cento; a média de consumo foi 4 vezes por dia; outras drogas consumidas foram maconha 80.8 por cento; benzodiazepinas 54.8 por cento.

A descriptive study was carried out to identify social, health and drug abuse characteristics of heroin addicts under treatment in CARISMA, from January 2003 till June 2008. Data were obtained from clinical charts. The average age was 22.6 years old, 74 percent were men, 39.7 percent belonged to mono-parental families, 47.9 percent came from low socio-economic classes, 50.7 percent were enrolled in professional education programs. Co-morbidities were depression and personality disorders in 32.9 percent. The most common drug abuse administration route was intravenous (74 percent), with an average consumption frequency of 4 times per day; other drugs consumed were: marihuana (80.8 percent), benzodiazepines (54.8 percent).

Diagnósticos de enfermagem, perfil social e clínico de adolescentes em tratamento para a drogadição em um centro de reabilitação de Medellin 2006 / Nursing diagnoses and clinical and social profile of adolescents addicted to drugs at a rehabilitation center in Medellin 2006

Através de uma pesquisa descritiva, foram determinados os diagnósticos de enfermagem mais freqüentes, e o perfil social e clínico de 50 jovens, dos quais foi avaliado o estado de saúde; e foi completado um instrumento baseado na NANDA, com o qual foi elaborada uma check-list de 35 diagnósticos, os mais repetidos dos quais foram selecionados. A média de idade foi 17.6 anos; a maioria era de homens, que pertenciam a uma família nuclear de baixo nível; a droga mais consumida foi maconha; a co-morbidade mais comum foi conduta sociopática. Os diagnósticos de enfermagem mais freqüentes: Desempenho de papel alterado; Interação social prejudicada; Ansiedade; Atividades de recreação deficientes; Conhecimentos deficientes; Isolamento social, Padrão de sono perturbado; Risco para violência direcionada aos outros. Conclui-se que a droga mais consumida por adolescentes dependentes é a maconha, e que as co-morbidades mais freqüentes são as patologias sociais e transtornos de conduta.