Prevención del suicidio en médicos / Suicide prevention in doctors

Se sabe que la tasa de suicidio en médicos es mayor que en la población general. La salud de los médicos ha recibido escasa atención de sus colegas, a pesar de la considerable y creciente evidencia de que la morbilidad es alta en la profesión. Cuidar de otras personas genera estrés en los cuidadores. El estrés por la incertidumbre clínica y el temor al fracaso son rasgos importantes de la cultura médica. La paradoja es que el cuidado de los pacientes genera estrés pero es también la fuente de gratificación más importante del médico. Se sabe que aquellos que cuidan de los demás a menudo tienen grandes dificultades para buscar y recibir ayuda para ellos mismos. Las tasas de suicidio de los médicos en Estados Unidos, Inglaterra y otros países son más altas que las de la población general y las de otras profesiones. La tasa de suicidio de los médicos es ligeramente mayor que la de la población general, mientras que la de las médicas es claramente superior. Esta tendencia es más pronunciada entre psiquiatras y anestesistas. Los médicos tienen unas necesidades asistenciales específicas por sufrir elevados niveles de alcoholismo, dependencia de drogas, rupturas matrimoniales, enfermedad mental y suicidio. La automedicación es muy frecuente entre los médicos, en especial con hipnóticos, antidepresivos y analgésicos opiáceos. Muchas de estas dificultades están relacionadas con el estrés, elevada responsabilidad y tiempo insuficiente para trabajar y vivir conciliando las demandas laborales y familiares. Muchos médicos tienen grandes dificultades para discutir sus problemas con los colegas y se tratan a ellos mismos, de forma notablemente peligrosa. El fácil acceso de los médicos a las drogas implica que el abuso de drogas sea un riesgo ocupacional potencial de hombres y mujeres (AU)

The rate of suicide in physicians is known to be higher than that of the general public. The health of doctors has always received scant attention from their colleagues, in spite of considerable and increasing evidence that morbidity and mortality are high in the profession. Caring for others imposes considerable strains on the careers. The stress by clinical uncertainty and the fear of failure are important parts of the medical ethos. It is recognized that those who do care for others often have great difficulty in asking for, and receiving, care for themselves. Suicide rates for doctors in the United States, United Kingdom and other countries are higher than general population and other professions. The suicide rate of male physicians is slightly higher than that of the general population, while that of their female colleagues is clearly higher. This tendency is most pronounced in female psychiatrist and anesthetists. Doctors have specific needs for health care by suffer abnormally high levels of alcoholism, drug dependence, marital breakdown, mental illness and suicide. The self-medication is common among doctors, particularly sleeping tablets, antidepressants and opiate analgesics. Many of the difficulties are related to stress, high responsibility and insufficient time to do the work and to live reconciling demands between work and family. Many doctors show an increased impediment for discuss their problems with colleagues, and treat themselves, which is notoriously hazardous. Doctors' easy access to drug makes drug abuse a potential occupational hazard for men and women (AU)

Tuberculosis among homeless population from Medellín, Colombia: associated mental disorders and socio-demographic characteristics.

Homeless people are highly susceptible to tuberculosis. It has been suggested that this population have high rates of mental disorders associated with tuberculosis. We assessed tuberculosis incidence, its transmission patterns and association with socio-demographic factors and mental disorders in Colombian homeless people. Prospective study which socio-demographic characteristics and mental disorders were assessed through interviews. Sputa from patients with respiratory symptoms were processed and clinical isolates analyzed by IS6110-RFLP. Multivariate analysis performed by logistic regression model. From 426 homeless studied, tuberculosis incidence found was 7.9 %. 44 % of isolates were clustering. It was found high risk of having tuberculosis associated with income from drugs trade (OR: 3.40 [95 % CI: 1.28-9.05]), dysthymia (OR: 2.54 [95 % CI: 1.10-5.86]) and receiving food from other homeless (OR: 2.47 [95 % CI: 1.16-5.25]). Tuberculosis incidence and degree of transmission are high in homeless studied. Implementing programs to better control tuberculosis among homeless population must consider socio-demographic factors and mental disorders associated with the disease.

Prevalencia de sintomatología depresiva y ansiosa en estudiantes de 14 a 18 años de un colegio privado de Medellín / Prevalence of Depressive and Anxious Symptomatology in 14-18 ys-old Students from a Private School in Medellin

Introducción: Este estudio busca determinar la prevalencia de los síntomas depresivos, ansiosos y factores de riesgo familiares, medioambientales y personales, en una población de adolescentes entre 14 y 18 años de edad de un colegio privado de Medellín. Métodos: Estudio observacional analítico de corte. Se aplicó una encuesta sociodemográfica, y las escalas de BAI (inventario de ansiedad de Beck) y BDI- II (inventario de depresión de Beck-II), para detectar la presencia de sintomatología ansiosa y depresiva. Resultados: Se encuestaron 152 adolescentes, el promedio de edad fue de 15,4 ± 0,9 años, la prevalencia de síntomas ansiosos fue de 25%, y de síntomas depresivos, de 25,7%. De los 38 (25%) estudiantes que tuvieron puntajes positivos en el BAI, 26 (68,4%) presentaron puntajes positivos en el BDI, y de los 39 (25,6%) alumnos que tuvieron puntajes positivos para BDI, en 26 (66,7%) se hallaron puntajes positivos para el BAI. Conclusiones: Los factores de riesgo para sintomatología ansiosa y depresiva fueron: ser mujer, ser víctima de matoneo y el maltrato. Tener amigos fue factor protector para sintomatología depresiva. Se encontró asociación estadística entre el autorreporte de sintomatología depresiva en el adolescente y sintomatología de ansiedad; entre el autorreporte de ansiedad con sintomatología depresiva; de igual manera, entre la sintomatología de depresión y ansiedad y la percepción de los padres para dichos síntomas.

Objective: This study describes prevalence of depressive and anxious symptoms together with family, environmental and personal risk factors in a group of adolescents between 14 and 18 years of age in a private school of Medellín. Methods: An analytic observational cross sectional study was performed in 152 adolescents, evaluating sociodemographic aspects and prevalence of depressive and anxious symptomatology, as established through BDI-II and BAI. Results: Average age was 15.4 ± 0.9 years old, with a 25% prevalence of anxiety symptoms and 25.7% of depressive symptoms. From the 38 (25%) students with BAI positive, 26 (68.4%) were BDI positive, and from the 39 (25.6%) students with BDI positive, 26 (66.7%) were BAI positive. Conclusions: the risk factors for anxiety and depressive symptomatology were: being a woman, being a victim of bullying and abuse. Having friends was the protective factors for depressive symptomatology. There was a statistical association between self-report of depressive and anxiety symptomatology; between the anxiety self-report and the depressive symptomatology; as well as between depressive and anxiety symptomatology and parents' perception of such symptoms.

[Prevalence of Depressive and Anxious Symptomatology in 14-18 ys-old Students from a Private School in Medellin]. / Prevalencia de sintomatología depresiva y ansiosa en estudiantes de 14 a 18 años de un colegio privado de Medellín.

OBJECTIVE: This study describes prevalence of depressive and anxious symptoms together with family, environmental and personal risk factors in a group of adolescents between 14 and 18 years of age in a private school of Medellín. METHODS: An analytic observational cross sectional study was performed in 152 adolescents, evaluating sociodemographic aspects and prevalence of depressive and anxious symptomatology, as established through BDI-II and BAI. RESULTS: Average age was 15.4 ± 0.9 years old, with a 25% prevalence of anxiety symptoms and 25.7% of depressive symptoms. From the 38 (25%) students with BAI positive, 26 (68.4%) were BDI positive, and from the 39 (25.6%) students with BDI positive, 26 (66.7%) were BAI positive. CONCLUSIONS: the risk factors for anxiety and depressive symptomatology were: being a woman, being a victim of bullying and abuse. Having friends was the protective factors for depressive symptomatology. There was a statistical association between self-report of depressive and anxiety symptomatology; between the anxiety self-report and the depressive symptomatology; as well as between depressive and anxiety symptomatology and parents' perception of such symptoms.