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.

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.

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.

[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.

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.

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.

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.