Subject(s)
Humans , Child , Mental Health , Armed Conflicts/psychology , COVID-19/psychology , Pandemics , SARS-CoV-2ABSTRACT
La adherencia de los pacientes a las indicaciones médicas es fundamental en la respuesta al tratamiento. En el caso de la epilepsia, una mala adherencia puede causar episodios de crisis epilépticas, hospitalizaciones y empeorar el pronóstico del paciente. En niños y adolescentes se ha descrito mala adherencia a los tratamientos antiepilépticos. Se han identificado factores que se relacionan a una mejor y peor adherencia, estar atentos a estos factores puede ayudar a mejorar la adherencia de los pacientes a tratamiento y prevenir complicaciones.
Patient's compliance to medical directions is essential in response to treatment. In the case of epilepsy, a low treatment compliance may result in seizures, hospitalizations and worsen the patients' long-term outcome. A low treatment adherence has been described in children and adolescents with epilepsy. There have been positive and negative factors identified for treatment adherence, physicians should be aware of them in order to improve the patients' compliance to treatment and help them have a better prognosis. Keywords: anticonvulsants, child, adolescent, treatment adherence and compliance.
Subject(s)
Humans , Child , Adolescent , Epilepsy/drug therapy , Treatment Adherence and Compliance , Anticonvulsants/therapeutic use , Medication AdherenceABSTRACT
Los trastornos de salud mental como depresión y ansiedad tienden a coexistir frecuentemente con los trastornos de somatización, siendo estos últimos una causa frecuente de consulta en especialidades médicas en niños y adolescentes. Es necesario poder pesquisarlos y diagnosticarlos para poder tratarlos adecuadamente. En la actualidad se cuenta con tratamientos eficaces y seguros para estos cuadros, ya sea estén aislados o en comorbilidad. Tanto la terapia cognitivo conductual como los inhibidores selectivos de recaptura de serotonina, solos o combinados, han demostrado ser intervenciones exitosas en estos niños y adolescentes. En el presente artículo se realiza una revisión de cómo se conceptualizan como una dimensión psicopatológica actualmente estos trastornos y cómo se relacionan entre ellos.
Psychiatric disorders such as depression and anxiety are frequently comorbid with somatization disorders, the latter ones are a common cause for medical specialties consultation in the pediatric population. It is thus necessary to identify and diagnose these disorders in order to be able to treat them. Currently, there are safe and effective treatments for these disorders, whether they are isolated or comorbid. Both cognitive behavioral therapy and selective serotonin reuptake inhibitors, alone or combined, have proven to be successful in treating these children and adolescents. This is a review of the current conceptualization of this psychopathologic dimension and how these disorders are interrelated.
Subject(s)
Humans , Child , Adolescent , Anxiety Disorders/psychology , Somatoform Disorders/psychology , Somatoform Disorders/therapy , Psychology, Child , Psychology, Adolescent , Depression/psychology , Anxiety Disorders/diagnosis , Anxiety Disorders/therapy , Somatoform Disorders/diagnosis , Depression/diagnosis , Depression/therapyABSTRACT
Revisión bibliográfica extensa de literatura nacional e internacional acerca del fenómeno del bullying. Se analiza la definición y descripción del problema desde una mirada amplia y sistémica, considerando el contexto en el que ocurre: la violencia social. Se revisa la prevalencia de la violencia entre pares a nivel internacional y un acercamiento a las cifras disponibles en escolares chilenos, junto con una actualización de la información acerca de los distintos actores involucrados en la dinámica bullying: agresores, víctimas, víctimas/agresores y testigos, describiendo sus características psicológicas, familiares, psicopatología y consecuencias tanto para los niños y adolescentes como para la sociedad en general. Se revisan las estrategias de prevención e intervención sobre el bullying y la violencia en general desde una mirada sistémica y científica crítica. Se sintetizan los aspectos generales y específicos de prevención (primaria, secundaria y terciaria), de acuerdo a la etapa del ciclo vital y se analiza el rol que cumple el clínico, la familia y la escuela en detectar y prevenir la violencia entre pares. Nos focalizamos en las estrategias de intervención escolar y se realiza una exhaustiva revisión de los programas escolares de prevención secundaria que han sido implementados en otros países, y que tienen efectividad comprobada científicamente.
The following paper is an extensive bibliographic review of the bullying phenomenon in international and national literature. We analyze the definition and description of bullying within its broader context: social violence. The national and international reports of the prevalence of violence within peers are presented, along with an update of the information available on the actors involved in the dynamics of bullying: aggressors (bullies), victims, bully-victims and witnesses, describing their psychological features, family characteristics, psychopathology and the consequences for the children, adolescents, and society in general. We critically reviewed the existing information on prevention and intervention strategies for bullying with a systemic and scientific outlook. Some aspects of prevention are synthesized (general and specific primary, secondary and tertiary prevention), according to the developmental stage of those involved. We analyze the role that clinicians, family and school play in preventing and detecting violence against peers. We focused on school-level interventions and a thorough description is made of the school programs for secondary prevention that have been implemented in developed countries and their effectiveness verified by scientific studies. Finally, we discuss that bullying has become a serious mental health problem for our children and adolescents as a new form of social violence. It has severe consequences for the development of our youngsters and must be recognized and evaluated in its real dimension by the multiple social actors involved. It is very important to evaluate this problem in the broader context in which it presents It self and to focus on prevention and intervention strategies according to the developmental stages of childhood and adolescence, the families involved and the scientific evidence available.
Subject(s)
Humans , Male , Adolescent , Female , Child , Aggression/psychology , Social Behavior , Students , Violence , Stress Disorders, Post-TraumaticABSTRACT
The purpose of this study was to determine the incidence, and the consequences, of abusive situations as perceived by students during the course of their medical training. A descriptive study was carried out surveying the entire 2000 fifth-year class of 181 in the Medical School of the University of Chile. The questionnaire was answered by 144 students. Results showed that 91.7% of the students who responded had suffered at least one episode of abuse while enrolled in medical school. The main offenders were teachers and peers. Verbal abuse was the most common (85.4%), followed by psychological (79.9%), sexual(26.4%) and physical (23.6%) abuse. Students reported that abuse had effects on their mental health, social life and the image they had of physicians; 17% considered dropping out of school as a consequence of this experience. Efforts should be addressed to prompt educators to reflect on their role.
Subject(s)
Agonistic Behavior/classification , Faculty, Medical , Schools, Medical , Students, Medical/psychology , Adult , Attitude of Health Personnel , Chile , Female , Humans , Incidence , Interprofessional Relations , Male , Organizational Culture , Peer Group , Sex Factors , Sexual Harassment/statistics & numerical data , Social Behavior , Social Environment , Surveys and QuestionnairesABSTRACT
BACKGROUND: Multiauthorship and unjustified authorship have been documented in journals with wide international circulation but this has not been thoroughly studied in journals from developing countries. Revista Médica de Chile is published in Spanish and it contains about 40% of the clinical and biomedical manuscripts generated by Chilean authors. OBJECTIVES: To evaluate temporal trends in the number of authors per article in Rev Med Chile and authors' compliance with the International Committee of Medical Journal Editors (ICMJE) criteria of authorship (updated 2001). DESIGN: A retrospective analysis of the number of authors per article between 1969 and 2000; and a prospective survey applying a contribution checklist to authors of manuscripts published in the year 2000. "Justified authorship" was assigned to whom self-declared contributions to: 1) conception and design of the study, or acquisition of data, or analysis and interpretation of data; 2) drafting the article, or critically reviewed it; and 3) approved the final version. "Partial authorship" to whom lacked one of those 3 criteria. "Unjustified authorship" was assigned to whom participated only in data collection, or in diagnostic/therapeutic procedures, or in the statistical analysis, or in combinations lacking the main descriptors required for justified authorship. RESULTS: The number of authors in research articles increased in the last decade: From 3.9 +/- 1.6 (mean +/- SD) in 1969 and 4.9 +/- 2.0 in 1989 to 5.7 +/- 2.5* in 1994, 5.2 +/- 2.6* in 1999 and 5.4 +/- 2.2* in 2000 (*p < 0.05 compared to previous years). In contrast, it remained stable in case reports (4.1 +/- 1.9) and in reviews, public health or medical education articles (3.3 +/- 1.8). Among 921 authors surveyed (90% of authors in the year 2000), 51.2% qualified for "justified authorship", 42.3% for "partial authorship" and only 6.4% for "unjustified authorship". CONCLUSIONS: In a medical journal from a developing country, multiauthorship has increased mildly in research articles. Most participants complied fully or partially with the ICMJE criteria of authorship. Creditable authorship can be improved by continuous education and a critical attitude by the authors, readers, reviewers and editors.
