Factores asociados al consumo de psicofármacos sin receta en Chile: estudio descriptivo basado en la Encuesta Nacional de Consumo de Drogas en Población General / Factors associated with the use of nonprescription psychotropic drugs in Chile: A descriptive study using a nationwide drug consumption survey

ANTECEDENTES El consumo de psicofármacos sin receta médica es un problema creciente de salud pública en todo el mundo, su uso indebido implica una serie de riesgos. OBJETIVO Determinar factores sociodemográficos y conductas asociadas al consumo de psicofármacos sin receta en Chile. MÉTODOS Estudio descriptivo a partir de los datos del XI Estudio Nacional de Drogas en Población General en Chile, año 2014, realizado en población entre 12 y 64 años (n = 19 512). Se estimó la prevalencia y se ajustó un modelo multivariado de regresión logística. Además, se realizó análisis de correspondencia múltiple. RESULTADOS La prevalencia de consumo de psicofármacos fue 2,3%. En población estudiada, los factores asociados son sexo femenino (Odds ratio: 1,4; intervalo de confianza 95%: 1,16 a 1,77), edades entre 20 y 29 (Odds ratio: 1,4; intervalo de confianza 95%: 0,98 a 2,26) y 40 y 49 años (Odds ratio: 1,8; intervalo de confianza 95%: 1,19 a 2,75), consumo de: marihuana (Odds ratio: 3,0; intervalo de confianza 95%: 3,32 a 3,97), cocaína o pasta base (Odds ratio: 3,7; intervalo de confianza 95%: 2,45 a 5,70), tabaco (Odds ratio: 1,4; intervalo de confianza 95%: 1,17 a 1,78), alcohol (Odds ratio: 1,3; intervalo de confianza 95%: 1,11 a 1,73) y mala percepción de salud (Odds ratio: 1,8; intervalo de confianza 95%: 1,51 a 2,28). De los perfiles, se vinculó a población de fuerzas armadas con consumo de analgésicos y antitusivos, a jóvenes de 19 a 25 años con consumo de estimulantes, a población de 45 a 64 años con mala percepción de salud asociada al consumo de tranquilizantes y a hombres de 12 a 18 años con uso de sustancias psicoactivas. CONCLUSIÓN Las prevalencias halladas concuerdan con datos en Latinoamérica, permitiendo evidenciar la relación que existe entre el consumo de psicofármacos con factores sociodemográficos, conductas de riesgo e identificación de perfiles de consumo.

BACKGROUND The consumption of psychotropic drugs without a medical prescription is a growing public health problem worldwide. Misuse or indiscriminate use involves several risks. OBJECTIVE To determine sociodemographic factors and behaviors associated with the consumption of psychotropic drugs without prescription in Chile. METHODS This is a descriptive study based on the data of the XI National Study of Drugs in the General Population in Chile, carried out in the population between 12 and 64 years old (n = 19 512) during 2014. Prevalence was estimated, and a multivariate logistic regression model was adjusted. Also, a multiple correspondence analysis was performed. RESULTS The prevalence of psychotropic drug use was 2.3%. In the studied population, associated risk factors are female sex (odds ratio: 1.4; 95% confidence interval: 1.16 to 1.77); ages between 20-29 (odds ratio: 1.4; 95% confidence interval: 0.98 to 2.26) and 40-49 (odds ratio: 1.8; 95% confidence interval: 1.19 to 2.75); consumption of marijuana (odds ratio: 3.0; 95% confidence interval: 3.32 to 3.97), cocaine or crack (odds ratio: 3.7; 95% confidence interval: 2.45 to 5.70); tobacco (odds ratio: 1.4; 95% confidence interval: 1.17 to 1.78); alcohol (odds ratio: 1.3; 95% confidence interval: 1.11 to 1.73); and poor health perception (odds ratio: 1.8; 95% confidence interval: 1.51 to 2.28). Military personnel used more pain and cough medication; young women between 19 to 25 years old used stimulants; the population between 45 to 64 years had a bad perception of health associated with the use of tranquilizers; and men between 12 and 18 years used illicit drugs. CONCLUSIONS The prevalence found in the different groups is consistent with data reported in Latin America, showing the relationship between the use of non-prescription psychotropic drugs with sociodemographic factors, risk behaviors, and the identification of consumption profiles.

Clinical and epidemiological features of myasthenia gravis in Chilean population.

OBJECTIVE: To provide an estimated prevalence and describe the clinical features of myasthenia gravis (MG) in Chile. METHOD: We carried out (i) a prevalence study of MG using the capture-recapture method and the hospital register of pyridostigmine prescription in South-East Santiago (ii) a nationwide survey of MG patients. RESULTS: Prevalence in adults in South-East Santiago was estimated to be 8.36/100 000 inhabitants (CI: 95%, 7.98-8.80). From the nationwide survey, 405 questionnaires were analysed, there was a female/male ratio of 2.2:1. The mean age of onset of symptoms was 38.7 years (range 1-89). The onset was ocular in 46.4%, oculobulbar in 11.6%, bulbar in 8.9%, limbs in 11.6% and generalized in 21.4%. Of the 13.3% of patients who had had a diagnosis of thymoma, only four of these patients were >60 years old at onset. Thymomas were commoner in patients living in mining counties. Patients ≥60 years old at onset of MG formed 19.5% of the sample, female/male ratio 0.97:1. Associated autoimmune diseases were reported in 14% of patients and in family members of 31.8% of patients. A total of 78 patients had to change work due to MG and 68 needed help in carrying out daily activities. CONCLUSIONS: This study reduces the gap in information about MG in South America. The prevalence of MG in Chile is within the range described worldwide. We did not see an increase in male frequency in the older age of onset group and thymoma was more frequent in the fifth and sixth decades.

[Systematic review of population-based studies of the prevalence of cataracts]. / Revisión sistemática de estudios poblacionales de prevalencia de catarata.

OBJECTIVE: The prevalence of cataracts has increased due to the progressive ageing of the population and the fact that cataracts affect a wide and increasing proportion of the population. The goal of the present study was to describe the prevalence of cataracts through a systematic and exhaustive review of population-based studies. METHODS: A systematic review of population-based studies of the prevalence and incidence of cataracts was performed. Inclusion criteria were: a healthy non- institutionalised population, older than 40 years of age, of white race, with a sample size of greater than 1,000 and published between 1980 and 2002. RESULTS: Ten studies met the inclusion criteria (3 European, 5 from the United States and 2 from Australia), and were performed between 1984 and 2001. The cataract prevalence, according to lens opacity criteria, ranged between 15% and 19%. When the cataract was defined as a lens opacity combined with a decreased visual acuity, the prevalence ranged from 15% to 30%. The overall prevalence increased with age, reaching 40% and more than 60% in populations older than 70 and 75 years respectively. The prevalence among women was higher than that among men, with a more marked increase being evident at older ages than for men. CONCLUSIONS: There were variations among the criteria used to measure the prevalence of cataract, which made it difficult to compare all the studies. Overall the prevalence was higher in the older population, especially among women. The increasing prevalence associated with age predicts an increasing burden of cataract to health services, this being particularly related to the ageing of the population.

Revisión sistemática de estudios poblacionales de prevalencia de catarata / Systematic review of population-based studies of the prevalence of cataracts

Objetivo: El envejecimiento de la población ha provocado un aumento de la prevalencia de cataratas afectando a una amplia y creciente proporción de la población. El objetivo del presente estudio es describir la prevalencia de catarata a partir de estudios poblacionales mediante una revisión bibliográfica sistemática y exhaustiva. Métodos: Se realizó una búsqueda sistemática de estudios poblacionales de prevalencia e incidencia de cataratas, realizados en población sana no institucionalizada, mayor de 40 años, de raza blanca, con una muestra superior a 1.000 individuos y cuyo año de publicación estuviera entre 1980 y 2002. Resultados: Diez estudios cumplieron con los criterios de inclusión (3 europeos, 5 de Estados Unidos y 2 australianos), realizados entre 1984 y 2001. La prevalencia de catarata según opacificación del cristalino en los estudios que la describen estaba entre el 15 y 19%. Cuando se define catarata como opacificación y nivel de agudeza visual conjuntamente los estudios describen prevalencias entre el 15 y 30%. La prevalencia aumenta con la edad, alcanzando entre un 40% y más del 60% de la población a partir de los 70/75 años. Las mujeres tienen una prevalencia mayor que los hombres, con un aumento más pronunciado en edades más avanzadas. Conclusiones: No existe una forma estandarizada de medir la prevalencia de catarata, lo que dificulta la comparación entre los estudios. La prevalencia de catarata fue mayor en los grupos de mayor edad y entre las mujeres, en especial en edades mayores. La creciente prevalencia asociada a la edad muestra el aumento de la carga poblacional de las cataratas asociada al envejecimiento de la población

Objective: The prevalence of cataracts has increased due to the progressive ageing of the population and the fact that cataracts affect a wide and increasing proportion of the population. The goal of the present study was to describe the prevalence of cataracts through a systematic and exhaustive review of population-based studies. Methods: A systematic review of population-based studies of the prevalence and incidence of cataracts was performed. Inclusion criteria were: a healthy non- institutionalised population, older than 40 years of age, of white race, with a sample size of greater than 1,000 and published between 1980 and 2002. Results: Ten studies met the inclusion criteria (3 European, 5 from the United States and 2 from Australia), and were performed between 1984 and 2001. The cataract prevalence, according to lens opacity criteria, ranged between 15% and 19%. When the cataract was defined as a lens opacity combined with a decreased visual acuity, the prevalence ranged from 15% to 30%. The overall prevalence increased with age, reaching 40% and more than 60% in populations older than 70 and 75 years respectively. The prevalence among women was higher than that among men, with a more marked increase being evident at older ages than for men. Conclusions: There were variations among the criteria used to measure the prevalence of cataract, which made it difficult to compare all the studies. Overall the prevalence was higher in the older population, especially among women. The increasing prevalence associated with age predicts an increasing burden of cataract to health services, this being particularly related to the ageing of the population