Child abuse, gender differences and their clinical and criminological implications in incarcerated individuals. / Maltrato infantil, diferencias de género y sus implicaciones clínicas y criminológicas en personas privadas de su libertad.

INTRODUCTION: Several studies show high rates of childhood traumatic events in subjects incarcerated in prison institutions. OBJECTIVE: To assess the prevalence and gender differences of different types of childhood adverse experiences and their correlation with psychopathological and criminological variables in incarcerated individuals. MATERIAL AND METHODS: An epidemiological, descriptive-observational study was conducted in two psychiatric prisons located in Argentina and 84 subjects of both sexes participated. A socio-demographic questionnaire was used, the SCID I and II scales and the Adverse Childhood Experiences questionnaire. RESULTS: 91.7% of the participants had suffered some adverse experience in childhood. A high rate of physical (63%) and emotional abuse (61%) was detected. We found gender differences in the type of child abuse and the crimes committed. Significant relationships were found between some childhood adverse events and psychiatric disorders, crimes committed and recidivism. CONCLUSIONS: In accordance with other studies, there was a high prevalence of adverse childhood experiences in incarcerated individuals and significant gender differences in the type of child abuse, in psychiatric disorders, in the crimes committed and recidivism.

Maltrato infantil, diferencias de género y sus implicaciones clínicas y criminológicas en personas privadas de su libertad

Introducción: Diversos estudios muestran elevados índices de eventos traumáticos infantiles en sujetos detenidos en instituciones carcelarias. Objetivo: El objetivo del estudio es evaluar la prevalencia y las diferencias de género de los diferentes tipos de experiencias adversas infantiles y su correlación con variables psicopatológicas y criminológicas en personas detenidas. Material y métodos: Se realizó un estudio epidemiológico descriptivo-observacional en 2 instituciones psiquiátricas penitenciarias ubicadas en la República Argentina. Participaron 84 personas de ambos sexos. Se utilizó un cuestionario sociodemográfico, las escalas SCID I y II y el Cuestionario de Experiencias Adversas Infantiles. Resultados: El 91,7% de los participantes habían padecido alguna experiencia adversa en su infancia. Se encontró una elevada tasa de abuso físico (63%) y emocional (61%). Hallamos diferencias de género en el tipo de maltrato infantil y en los delitos cometidos. Se encontraron relaciones significativas entre algunos eventos adversos infantiles y trastornos psiquiátricos, delitos cometidos y reincidencia. Conclusiones: En concordancia con otros estudios, se observó elevada prevalencia de experiencias adversas infantiles en personas detenidas y diferencias de género significativas en el tipo de maltrato infantil, los trastornos psiquiátricos, los delitos cometidos y la reincidencia.

Introduction: Several studies show high rates of childhood traumatic events in subjects incarcerated in prison institutions. Objective: To assess the prevalence and gender differences of different types of childhood adverse experiences and their correlation with psychopathological and criminological variables in incarcerated individuals. Material and methods: An epidemiological, descriptive-observational study was conducted in two psychiatric prisons located in Argentina and 84 subjects of both sexes participated. A socio-demographic questionnaire was used, the SCID I and II scales and the Adverse Childhood Experiences questionnaire. Results: 91.7% of the participants had suffered some adverse experience in childhood. A high rate of physical (63%) and emotional abuse (61%) was detected. We found gender differences in the type of child abuse and the crimes committed. Significant relationships were found between some childhood adverse events and psychiatric disorders, crimes committed and recidivism. Conclusions: In accordance with other studies, there was a high prevalence of adverse childhood experiences in incarcerated individuals and significant gender differences in the type of child abuse, in psychiatric disorders, in the crimes committed and recidivism.

The history of multiple adverse childhood experiences in patients with schizophrenia is associated with more severe symptomatology and suicidal behavior with gender-specific characteristics.

The current study aims to compare the prevalence of adverse childhood experiences (ACEs) between patients with schizophrenia and non-psychiatric control group, and to analyze the association of having suffered multiple ACEs with clinical symptoms of schizophrenia and suicidal behavior. A multicenter, cross-sectional study was conducted across three facilities in Buenos Aires, Argentina. One-hundred patients with schizophrenia and 50 healthy subjects were assessed with the Adverse Childhood Experiences questionnaire (ACE-Q), the Positive and Negative Syndrome Scale (PANSS), and the Columbia-Suicide Severity Rating Scale (C-SSRS). We observed that the prevalence of at least one ACE in schizophrenic patients was almost double in comparison with the non-psychiatric control group. Multiple ACEs were associated with persistent auditory hallucinations and lower negative symptoms in both sexes. Higher frequency of death ideation and a higher number of suicide attempts were reported among women. The strength of this study is the possibility of comparing the presence of ACEs between schizophrenic patients and non-psychiatric control using the same questionnaire in an under-reported sample of low socio-economic patients assisted in public hospitals. A limitation is that the history of ACEs relied on the retrospective assessment of childhood experiences, and adults could over-report ACEs because of recall bias.

Prevalence and clinical impact of childhood adversities in women with schizophrenia.

Patients with schizophrenia have higher rates of adverse childhood experiences (ACEs) than the general population, and those who suffered multiple traumatic experiences have a higher prevalence of positive symptoms, poorer social functioning and more suicidal ideations and behavior. The current study aims to determine the prevalence of ACEs in a female patient sample with schizophrenia. An observational descriptive cross-sectional study was conducted. Participants included 50 female patients older than 18 years, with schizophrenia. Semi-structured interviews and the Adverse Childhood Experiences Questionnaire were conducted. We observed that 90% experienced at least one ACE. Most (52%) suffered 4 or more ACEs. A high prevalence of emotional abuse and neglect was found and a significant relationship between patients who suffered multiple ACEs and the presence of suicidal behavior and persistent auditory hallucinations.

Differences in social cognition between male prisoners with antisocial personality or psychotic disorder.

The objective of this work is to discriminate between different neurocognitive circuits involved in empathy, one of them linked to emotional processing and the other associated with cognitive function. This is evaluated through the use of neuropsychological tools (Hinting Task, Reading the Mind in the Eyes Test and Cambridge Mind Reading Test) empathic cognition and empathic emotion. In this study, 57 male prisoners were divided into three groups: psychotic patients (20), antisocial patients (17), and a control group (20). Patients with psychosis were found to have significantly lower scores than the antisocial and control groups in a social reasoning test, but using tests of emotional recognition, we found that both psychotic patients and antisocial subjects scored significantly lower than the control group.

El objetivo de este trabajo es discriminar diferentes circuitos neurocognitivos involucrados en la empatía, uno de ellos vinculado al procesamiento emocional y otro asociado con la función cognitiva. Evaluamos mediante el uso de herramientas neuropsicológicas (Hinting Task, Reading the Mind in the Eyes Test y Cambridge Mind Reading Test) la cognición empática y la emoción empática. Participaron del estudio, 57 presos varones que se dividieron en tres grupos: pacientes psicóticos (20), antisociales (17) y un grupo control (20). Se encontró que los pacientes con psicosis tenían puntuaciones significativamente más bajas que los grupos antisociales y de control en una prueba de razonamiento social, pero utilizando pruebas de reconocimiento emocional, encontramos que tanto los pacientes psicóticos como los sujetos antisociales obtuvieron puntuaciones significativamente más bajas que el grupo control.

Adverse Childhood Experiences among Men with Schizophrenia.

Individuals who suffered traumatic events or adverse experiences during their childhood have an increased risk of developing during adulthood physical problems, aggressive behavior, and psychiatric disorders, such as schizophrenia. Patients diagnosed with schizophrenia have higher rates of traumatic experiences during childhood than the general population, and those who suffered multiple traumatic events have an increased risk of disease relapse. The current study aims to determine the prevalence of different types of adverse experiences during childhood among a male patient sample with schizophrenia. An Observational descriptive cross-sectional study was conducted at Jose T. Borda Hospital, in Buenos Aires, Argentina. Participants included 51 male patients between the ages of 18 and 63 years with a diagnosis of schizophrenia. Semi-structured interviews were conducted, applying a socio-demographic questionnaire, SCID I and II scales to assess psychiatric diagnosis, and the Adverse Childhood Experiences (ACE) Questionnaire to evaluate the presence of adverse childhood experiences. Statistical analyses were conducted using SPSS 22 software. We observed that 94% of participants had experienced at least one adverse childhood experience. Most (63%) suffered from 4 or more disruptive child events. A high prevalence of family history of mental illness was found, also emotional abuse and neglect. Most traumatic events occurred within the family group. It was found a moderately significant relationship between patients who suffered adverse events and the presence of auditory hallucinations.

Programa de especialistas para la atención primaria: experiencia y visión de académicos de la Universidad de Chile al primer año de marcha / Specialists for primary care: experience and academic opinions at the University of Chile after the program´s first year

El año 2008, los Departamentos de Medicina, Obstetricia, Ginecología y Pediatría y Cirugía Infantil, del Campus Occidente de la Facultad de Medicina de la Universidad de Chile, iniciaron un programa de 6 años para formar Especialistas para la Atención Primaria. PROPÓSITO: Relatar la experiencia, a 12 meses de iniciada. El Programa alterna rotaciones de 6 meses en la Facultad y en el sitio original de trabajo –en atención primaria– y surgió de un acuerdo con el Ministerio de Salud. En la Facultad la idea fue acogida con interés, pero no sin reservas. El artículo relata las reservas iniciales, con su evolución respectiva, y muestra la forma en que se ha desarrollado la experiencia durante su primer año. MATERIAL Y MÉTODO: Se presentan las opiniones del grupo de académicos ejecutores directos en el Campus Occidente. RESULTADOS: Se diseñó un programa de igual exigencia que el programa tradicionales de tres años pero de doble duración para dejar espacio a las rotaciones por Atención Primaria. Esto ha obligado a implementar muchas medidas (sistema de registro riguroso de experiencias, calificaciones, decisiones, permisos, etc.; reuniones de seguimiento y evaluación de las partes involucradas), recurrir a la creatividad de los académicos y flexibilizar la metodología del programa tradicional, de tres años. CONCLUSIONES: Hasta el momento, la experiencia es altamente satisfactoria y estimulante para la Facultad. No se ha sufrido dificultades mayores y los alumnos están satisfechos. Entre algunas de las múltiples ventajas adicionales que parece mostrar este programa, estos becados han servido de nexo entre sus consultorios de base y nuestros servicios hospitalarios, con los consecuentes beneficios para la población beneficiaria, lo que representa una fortaleza no menor porque lograría dar consistencia a la red de salud. Naturalmente, se mantendrá vigilancia sobre los aspectos...

In 2008 the three Departments of Medicine, Obstetrics and Gynecology and Pediatrics and Infantile Surgery of the Western Campus of the University of Chile began a new 6 years program to train specialist physicians for Primary Care in Internal Medicine, Obstetrics and Gynecology and Pediatrics. The Program alternates 6 months shifts at the Faculty and at original working places in primary care and emerged after an agreement between the Faculty and the Ministry of Health. AIM: To document the first 12 months of this experience. At a Faculty the idea was welcomed with a combination of interest and doubts. This article documents the evolution of these doubts and the way the experience has evolved along its first year. MATERIAL AND METHOD: Academic opinions of directly involved leading Professors of the Program are summarized and presented. RESULTS: Program design kept same objectives than the original 3 years program but doubled to 6 years to give place to primary care shifts. This requirement led to the implementation of several measures (strict records for academic experiences, grades, decisions, permissions; follow up and regular evaluation meetings with all involved people), academic creativity as well as the development of higher flexibility than the traditional three years program. CONCLUSIONS: Up to this moment experience has shown highly satisfactory and stimulant characteristics for the Faculty. No major difficulties have occurred and students declare satisfaction. Among several additional observed advantages students have linked their original working places and hospital with clear benefits for served population. This has become a major strength providing better consistency to the health network. Naturally, all aspects to make a sound evaluation of the experience will be kept under close surveillance. There is a plain belief that by the end of the training period specialist level will be comparable to the traditional specialization program.