ABSTRACT
(1) Background: There is consistent evidence of the impact of early adverse experiences on mental health in adulthood, especially as a risk factor for depression. However, their influence on positive aspects of mental health such as well-being has been less extensively studied. Therefore, this study aims to investigate the effect of traumatic childhood experiences on the relationship between depression and psychological well-being in a sample of university students. (2) Methods: The Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Beck Depression Inventory (BDI-IA), and Ryff's psychological well-being scale were administered to 700 Chilean university students. Several regression models were used to analyze the interaction between variables, with multivariate SEM being applied to hierarchize the relationships found. (3) Results: Emotional Neglect and Abuse stand out as the types of maltreatment with the greatest impact on mental health, associated first with a decrease in the self-acceptance dimension of psychological well-being and then with depressive symptomatology in adulthood. (4) Conclusions: Results provide evidence that early trauma has an important impact on mental health, increasing the risk of depression, however, its impact is greater on positive aspects of health, such as self-acceptance, a fundamental element in the construction of psychological well-being.
ABSTRACT
BACKGROUND: Quality of life and psychological well-being are readily hampered by depression. The changes that students face during college life impact their psychological health and well-being, including the emergence of mental health problems like depression Aim: To determine the relationship between depressive symptoms, sociodemographic parameters and psychological well-being in undergraduate university students. MATERIAL AND METHODS: Five hundred eighty university students of both sexes, from the Metropolitan and IX Regions of Chile answered the Beck Depression Inventory (BDI-IA) and the Ryff's psychological well-being scale. RESULTS: Twenty eight percent of respondents had clinically significant depressive symptoms, and these were more frequent in women. There was an inverse and statistically significant relationship between psychological well-being and depressive symptoms. This fact was especially marked in dimensions of autonomy, positive relationships with others and purpose in life. CONCLUSIONS: There is a high frequency of depressive symptoms among these students. We discuss whether psychological well-being and depressive symptomatology represent two extremes within a continuum or they are two independent dimensions that can account for differential causal mechanisms linked to mental health and illness.
Subject(s)
Depression/epidemiology , Quality of Life/psychology , Students/psychology , Adolescent , Adult , Chile/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Psychiatric Status Rating Scales , Sex Distribution , Sex Factors , Socioeconomic Factors , Universities/statistics & numerical data , Young AdultABSTRACT
Background: Quality of life and psychological well-being are readily hampered by depression. The changes that students face during college life impact their psychological health and well-being, including the emergence of mental health problems like depression Aim: To determine the relationship between depressive symptoms, sociodemographic parameters and psychological well-being in undergraduate university students. Material and Methods: Five hundred eighty university students of both sexes, from the Metropolitan and IX Regions of Chile answered the Beck Depression Inventory (BDI-IA) and the Ryff's psychological well-being scale. Results: Twenty eight percent of respondents had clinically significant depressive symptoms, and these were more frequent in women. There was an inverse and statistically significant relationship between psychological well-being and depressive symptoms. This fact was especially marked in dimensions of autonomy, positive relationships with others and purpose in life. Conclusions: There is a high frequency of depressive symptoms among these students. We discuss whether psychological well-being and depressive symptomatology represent two extremes within a continuum or they are two independent dimensions that can account for differential causal mechanisms linked to mental health and illness.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Quality of Life/psychology , Students/psychology , Depression/epidemiology , Psychiatric Status Rating Scales , Socioeconomic Factors , Universities/statistics & numerical data , Chile/epidemiology , Sex Factors , Cross-Sectional Studies , Sex DistributionABSTRACT
Recent research in psychiatric genetics has led to a move away from simple diathesis-stress models to more complex models of psychopathology incorporating a focus on gene-environment interactions and epigenetics. Our increased understanding of the way biology encodes the impact of life events on organisms has also generated more sophisticated theoretical models concerning the molecular processes at the interface between "nature" and "nurture." There is also increasing consensus that psychotherapy entails a specific type of learning in the context of an emotional relationship (i.e., the therapeutic relationship) that may also lead to epigenetic modifications across different therapeutic treatment modalities. This paper provides a systematic review of this emerging body of research. It is concluded that, although the evidence is still limited at this stage, extant research does indeed suggest that psychotherapy may be associated with epigenetic changes. Furthermore, it is argued that epigenetic studies may play a key role in the identification of biomarkers implicated in vulnerability for psychopathology, and thus may improve diagnosis and open up future research opportunities regarding the mechanism of action of psychotropic drugs as well as psychotherapy. We review evidence suggesting there may be important individual differences in susceptibility to environmental input, including psychotherapy. In addition, given that there is increasing evidence for the transgenerational transmission of epigenetic modifications in animals and humans exposed to trauma and adversity, epigenetic changes produced by psychotherapy may also potentially be passed on to the next generation, which opens up new perspective for prevention science. We conclude this paper stressing the limitations of current research and by proposing a set of recommendations for future research in this area.
ABSTRACT
Resumen El presente estudio explora la relación entre las dimensiones de personalidad dependiente y autocrítica, con los déficits emocionales, cognitivos y sociales asociados a la sintomatología depresiva. La muestra del estudio la conformaron 91 estudiantes universitarios pertenecientes a la Pontificia Universidad Católica de Chile y a la Universidad de Chile, con edades comprendidas entre los 18 y 24 años. Para explorar el estado emocional de los participantes se utilizaron los test Inventario de Depresión de Beck (BDI) y Depressive Experiences Question naire (DEQ). Con el fin de evaluar el desempeño cognitivo, se utilizaron: una tarea tipo Stroop y la prueba de Tiempo de Reacción Serial (SSRT), y para evaluar el nivel de mentalización, la tarea de reconocimiento facial Reading the Mind in the Eyes Task (RMET) de Baron-Cohen. Se encontraron correlaciones significativas entre las dimensiones dependencia y autocrítica, la sintomatología depresiva y el desempeño cognitivo de los participantes.
Abstract This study examines the relationship between the dependent and self-criticism Cognitive dimensions of personality with emotional, cognitive and social deficits associated with depres-sive symptoms. The sample included 91 college students, aged 18 to 24, from Pontificia Universidad Católica de Chile and Universidad de Chile. The Beck Depression Inventory (BDI) and the Depressive Experiences Questionnaire (DEQ) tests were used in order to explore the emotional state of the participants. A Stroop task and a Serial Reaction Time (SSRT) test were used in order to assess cognitive performance. In turn, the Reading the Mind in the Eyes Task (RMET) face recognition task, by Baron-Cohen, was used to assess the mentalising capacity. Sig nificant correlations were found between dependency and self-criticism dimensions, depressive symptoms and cognitive performance of the participant.
Subject(s)
Animals , Male , Female , Young Adult , Depression , Self-Assessment , Dependency, Psychological , Stroop TestABSTRACT
Research on the potential role of gene-environment interactions (GxE) in explaining vulnerability to psychopathology in humans has witnessed a shift from a diathesis-stress perspective to differential susceptibility approaches. This paper critically reviews methodological issues and trends in this body of research. Databases were screened for studies of GxE in the prediction of personality traits, behavior, and mental health disorders in humans published between January 2002 and January 2015. In total, 315 papers were included. Results showed that 34 candidate genes have been included in GxE studies. Independent of the type of environment studied (early or recent life events, positive or negative environments), about 67-83% of studies have reported significant GxE interactions, which is consistent with a social susceptibility model. The percentage of positive results does not seem to differ depending on the gene studied, although publication bias might be involved. However, the number of positive findings differs depending on the population studied (i.e., young adults vs. older adults). Methodological considerations limit the ability to draw strong conclusions, particularly as almost 90% (n = 283/315) of published papers are based on samples from North America and Europe, and about 70% of published studies (219/315) are based on samples that were also used in other reports. At the same time, there are clear indications of methodological improvements over time, as is shown by a significant increase in longitudinal and experimental studies as well as in improved minimum genotyping. Recommendations for future research, such as minimum quality assessment of genes and environmental factors, specifying theoretical models guiding the study, and taking into account of cultural, ethnic, and lifetime perspectives, are formulated.
ABSTRACT
BACKGROUND: Diverse and sustained efforts have been developed to improve the management of depression by general practitioners (GPs), but they have not improved treatment coverage and quality of services. AIM: To explore the level of knowledge and clinical skills to diagnose and treat depression by GPs in Primary Health Care (PHC) in the Metropolitan Area of Santiago de Chile (RM). MATERIAL AND METHODS: Theoretical knowledge (TK), diagnostic skills (DS) and treatment skills (TS) were evaluated in 56 GPs of the RM with a battery of specially designed instruments. RESULTS: In TK there were significant differences between GPs aged 31 years or less and their older counterparts and between Chilean and foreign doctors. Five percent of observed differences in TK were explained by age and nationality, respectively. Chilean GPs achieved higher scores in recognition of symptoms (RS), one of the dimensions of DS. No significant differences by age or nationality were observed for DS and TS. CONCLUSIONS: Achievement of GPs on tests measuring TK, DS, and TS was generally below 50%. This deficiency should be improved.
Subject(s)
Clinical Competence , Depressive Disorder/diagnosis , General Practitioners/standards , Adult , Chile , Depressive Disorder/therapy , Female , Humans , Male , Practice Patterns, Physicians' , Primary Health Care , Quality ImprovementABSTRACT
Background: Diverse and sustained efforts have been developed to improve the management of depression by general practitioners (GPs), but they have not improved treatment coverage and quality of services. Aim: To explore the level of knowledge and clinical skills to diagnose and treat depression by GPs in Primary Health Care (PHC) in the Metropolitan Area of Santiago de Chile (RM). Material and Methods: Theoretical knowledge (TK), diagnostic skills (DS) and treatment skills (TS) were evaluated in 56 GPs of the RM with a battery of specially designed instruments. Results: In TK there were significant differences between GPs aged 31 years or less and their older counterparts and between Chilean and foreign doctors. Five percent of observed differences in TK were explained by age and nationality, respectively. Chilean GPs achieved higher scores in recognition of symptoms (RS), one of the dimensions of DS. No significant differences by age or nationality were observed for DS and TS. Conclusions: Achievement of GPs on tests measuring TK, DS, and TS was generally below 50%. This deficiency should be improved.
Subject(s)
Humans , Male , Female , Adult , Clinical Competence , Depressive Disorder/diagnosis , General Practitioners/standards , Primary Health Care , Practice Patterns, Physicians' , Chile , Depressive Disorder/therapy , Quality ImprovementABSTRACT
BACKGROUND: There are suggestions that, despite training efforts for Primary Health Care physicians, difficulties in making accurate diagnoses and timely treatments persist. AIM: To evaluate the impact of a new training model in Depressive disorders integrated with Mindful Practice, on the diagnostic and therapeutic skills of primary care general physicians. MATERIAL AND METHODS: A voluntary sample of 56 general physicians was studied. The design of this study was experimental and randomized, with two groups attending theoretical sessions followed by differing workshops that were carried out in a parallel fashion. The Quantitative phase of this study considered measuring the impact of training in physician's skills. The Qualitative phase included nine semi-structured interviews and Qualitative Content Analysis. This paper reports the results of the interviews. RESULTS: As a consequence of training sessions, physicians learned that above the mental health problems, other issues such as self-efficacy and self-confidence are important for the management of depressive patients. CONCLUSIONS: This qualitative study shows that physicians are obtaining significant benefits from their training sessions.
Subject(s)
Clinical Competence , Depressive Disorder , Physicians, Primary Care/education , Qualitative Research , Adult , Attitude of Health Personnel , Depressive Disorder/diagnosis , Depressive Disorder/therapy , Female , Humans , Interviews as Topic , Male , Middle AgedABSTRACT
Depression has a high impact on mental health. However its diagnosis is a challenge even for specialists. This problem derives from a failure in an adequate description and differentiation of the disease. This inadequate conceptualization generates these difficulties. Our thesis is that depression should be understood as a complex phenomenon that can be analyzed from multiple perspectives, from genes to behavior, including personality and interaction with the sociocultural environment. The aim of this paper is to review the psychopathological construct of depression from a multidimensional point of view, considering clinical, sociocultural, characterological and pathogenic variables. Finally we provide a proposal for an adequate diagnostic approach.
Subject(s)
Humans , Depression/diagnosis , Depression/etiology , PersonalityABSTRACT
Depression has a high impact on mental health. However its diagnosis is a challenge even for specialists. This problem derives from a failure in an adequate description and differentiation of the disease. This inadequate conceptualization generates these difficulties. Our thesis is that depression should be understood as a complex phenomenon that can be analyzed from multiple perspectives, from genes to behavior, including personality and interaction with the sociocultural environment. The aim of this paper is to review the psychopathological construct of depression from a multidimensional point of view, considering clinical, sociocultural, characterological and pathogenic variables. Finally we provide a proposal for an adequate diagnostic approach.
Subject(s)
Depression/diagnosis , Depression/etiology , Humans , PersonalityABSTRACT
La enfermedad bipolar es relativamente frecuente en especial si se consideran las formas atenuadas del
Introduction: bipolar disorder is a relatively common disease, specially if we consider the bipolar spectrum. There are few studies in Latin America on the subject. Our objective was to evaluate the opinion of patients with bipolar disorder about its diagnosis and treatment. Methods: a survey was applied to 69 patients with type I and II bipolar disorder (DSM-IV), and the data were analyzed according to average, standard deviation and test of Chi-squared. Results: we found a high latency between the onset o the symptoms and the correct diagnosis of bipolar disorder: in 61% of the cases there was a gap of 11,9 years. In 38% of the cases, patients consulted more than four professionals before being given the correct diagnosis. The most frequent diagnostic error was schizophrenia (29%) and major depression (31%). In relation to pharmacotherapy, the most negative subjective experience was with classic antipsychotics. Nevertheless favorable therapeutics effects are perceived much more frequently. In 75% of the patients the impact of the disease was significant, especially in relation to work (24%) and relationships with partners (16%). Conclusions. Bipolar disorder is frequently confused with schizophrenia and major depression, the patients´ opinion of drugs is favorable and they perceive a great psychosocial impact on their daily life(AU)
Subject(s)
Humans , Male , Female , Bipolar Disorder/complications , Bipolar Disorder/epidemiology , Schizophrenia/epidemiology , Depression/complications , Depression/epidemiology , Social Support , Psychosocial Impact , Diagnostic and Statistical Manual of Mental Disorders , Socioeconomic SurveyABSTRACT
Se describe el proceso de implementación de programa de Interconsulta psiquiátrica docente para residentes, realizado por el Departamento de Psiquiatría y Salud Mental de la Facultad de Medicina de la Universidad de Chile entre 2003 y 2004. Método: Se establece programa preliminar, con objetivos y pautas de evaluación de cumplimiento de objetivos por parte de residentes. Resultados: Se destaca evaluaciones en el rango superior que los residentes hacen de objetivos docentes. Más bajos fueron evaluados los objetivos asistenciales. Supervisores evalúan positivamente el proceso en general, identificando las principales dificultades observadas: entre ellas la doble agenda presente en el proceso complejo propio de la actividad y de los objetivos docentes. Se destaca la importancia de la supervisión docente, la cual debería ser activa, vigilar las áreas que obstaculizan el proceso; mayores dificultades provenientes de demandas implícitas o explícitas subyacentes operaron como resistencias en los profesionales de salud general:"demandas urgentes" y "pacientes emocionalmente sobrepasados" postergarían la adecuada y oportuna acogida y tratamiento de los problemas de salud mental presentados. Tanto el docente - supervisor como el residente deberían advertir oportunamente estas resistencias para ayudar a superar estas barreras; entonces el profesional de salud general sería capaz de acoger y responder a las demandas emocionales explícitas o implícitas presentadas en la entrevista. Conclusión: No obstante la complejidad del proceso descrito, la interconsulta psiquiátrica es muy bien valorada por todos los actores involucrados en proveer atención a pacientes que presentan problemas de salud mental en servicios de salud general (AU)
Authors describe an initial program for training residents as consultants in Primary Care Settings. This program was developed and applied by the Department of Psychiatry and Mental Health of the Faculty of Medicine of the Universidad de Chile between 2003 and 2004. Method: Preliminary program was established, with objectives and evaluation schemes for the correct achievement of the objectives by the residents in two areas: learning and clinical work. Residents were assigned to different primary health centers, under a supervisor. Results: Good evaluations (superior rank) for residents' achievements in learning objectives were observed. Lower ratings were for clinical objectives. Supervisors evaluated the whole process positively; the main difficulty mentioned was the double work schedule required in the whole process of Psychiatry Consultant-laison in Primary settings. The discussion emphasizes the importance of supervision, which should be active in watching areas that hinder the process; making it necessary to detect problems in need of change to be established as soon as possible. Greater difficulties were originated on explicit and/or underlying medical or general health care team resistances. "Urgent demands and emotionally overwhelming patients delayed competent reception and treatment. Supervisor and resident should offer proper and timely advice, to allow the overcoming of the difficulties, then general health professionals would be able to manage the emotional demands, explicit or tacit, presented in the interview. Some elements should be treated in the process, itself complex, of teaching consultant-liaison during the psychiatry resident program. Conclusion: Nevertheless, psychiatry consultant-liaison in primary care settings was highly appreciated as necessary by all the actors involved in providing care for patients presenting mental health problems in primary health care settings (AU)
