ABSTRACT
INTRODUCTION: A burn injury is a very painful experience, with subsequent emotional problems, which have been gaining relevance to the extent that survival from burns has improved. Among the alterations of the mental sphere in this population is Acute Stress Disorder (ASD) that has been described in up to one-third of patients with major burns. METHODOLOGY: A nested case-control study was carried out in a cohort of hospitalized patients in a burn referral unit, in patients over 16 years of age. A total of 135 patients, 41 cases, and 94 controls were included. All of them underwent a psychiatric interview, a standardized form was filled out on sociodemographic and clinical information, and the PID-5-BF scale was applied to evaluate associated personality elements. The diagnosis of acute stress was made with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. RESULTS: The incidence of acute stress was 23.4%. When the clinical and sociodemographic characteristics of both the cases and the controls were compared, the risk factors were subsidized insurance, flame burn, burn in a special area, third-degree burn, high pain, stay in the Intensive Care Unit (ICU), peritraumatic amnesia and life threat. Patients also had a higher percentage of burned body surface, higher average pulse, longer hospital length of stay, higher average in the negative affect variable and in the psychoticism variable of the PID-5-BF scale. But for the multivariate analysis using logistic regression, the model that best explains the presence of acute stress only includes the variables life threat (Odds Ratio adjusted (ORa): 117.0; Confidence Interval (CI): 10.9-1258.5), severe pain (ORa: 9.9; CI: 1.8-52.8), electrical burn (ORa: 20.8; CI: 17.2-250), burn in a special area (ORa: 8.9; CI: 1, 0-76.8), third-degree burn (ORa: 10.4; CI: 0.7-166.7). CONCLUSION: Acute stress disorder is frequent in the hospitalised burn population, and is more frequent than in other types of trauma. Associated factors with the presentation of Acute Stress Disorder are the feeling of life threat at the time of the burn, having pain classified as strong (Visual Analog Scale (VAS) 5-10), electrical burn, and burns in special areas.
Subject(s)
Burns, Electric , Burns , Stress Disorders, Traumatic, Acute , Burns/complications , Burns/epidemiology , Burns, Electric/complications , Case-Control Studies , Humans , Length of Stay , Pain/complications , Retrospective Studies , Stress Disorders, Traumatic, Acute/epidemiologyABSTRACT
Introducción: El suicidio conforma una problemática de salud pública global, con múltiples características y factores de riesgo, que posee rasgos comunes y particulares de cada etapa del ciclo vital y de las edades de las personas que lo efectúan. Objetivo: Realizar una revisión de la literatura médica y de las entidades que tienen como tema el suicidio en el anciano, con el fin de plasmar la situación actual de esta problemática en el mundo y principalmente en Colombia. Método: Revisión de la literatura. Resultados: Durante la búsqueda se evidencia un alto volumen de producción literaria respecto al suicidio en general, incluso en Colombia se encuentra un número importante de artículos que describen la problemática de una forma global; sin embargo, se halla una deficiencia en literatura que referencie específicamente el acto en la edad adulta mayor.
Introduction: Suicide is a public health problem worldwide, with multiple features and risk factors. It has some common and unique trends in each phase across the lifespan. Objective: To review the medical literature related to suicide in the elderly, in order to determine the current status of this problem in the world, and especially in Colombia. Method: Literature review. Results: There is a high volume of articles about suicide in general, even in Colombia, with many papers describing the problem in a comprehensive manner, but there is a need for more studies and publications on the scope of this problem in the elderly.
Subject(s)
Humans , Male , Female , Aged , Suicide , Aged , Review Literature as Topic , Public HealthABSTRACT
INTRODUCTION: Suicide is a public health problem worldwide, with multiple features and risk factors. It has some common and unique trends in each phase across the lifespan. OBJECTIVE: To review the medical literature related to suicide in the elderly, in order to determine the current status of this problem in the world, and especially in Colombia. METHOD: Literature review. RESULTS: There is a high volume of articles about suicide in general, even in Colombia, with many papers describing the problem in a comprehensive manner, but there is a need for more studies and publications on the scope of this problem in the elderly.
ABSTRACT
Introduction: Obstructive sleep apnea is one of the most common sleep disorders, and is characterized by recurrent collapse of the upper airway during sleep caused suddenly, with a subsequent decrease in blood oxygen's saturation and has repercussions in the patient's general condition. Aim: To describe the characteristics of this association according to the available medical evidence. Report: The mechanisms of association of sleep apnea with psychiatric disorders are not well defined. However the coexistence of depressive symptoms with this condition has been documented and refractoriness in the treatment of psychiatric disorders when there is comorbidity. Although there is more evidence linking psychiatric disorders with obstructive sleep apnea, there is some evidence linking depressive disorders and anxiety symptoms, comorbid sleep apnea, which alerts the active search for both conditions in patients one of the diagnoses. Conclusions: Physicians should suspect obstructive sleep apnea in patients with refractory depression mainly chronic snoring, short and wide neck, a high body mass index and excessive daytime sleepiness.
Introducción: La apnea obstructiva del sueño es una de las alteraciones más comunes del dormir, se caracteriza por colapsos recurrentes de la vía aérea superior causados repentinamente durante el sueño, con posterior disminución de la saturación de oxígeno en sangre y repercusiones en el paciente en su estado general. Objetivo: Describir las características de esta asociación conforme a la evidencia médica disponible. Desarrollo: Los mecanismos de asociación de la apnea del sueño con trastornos psiquiátricos no están bien definidos. Sin embargo, se ha documentado la coexistencia de síntomas depresivos con esta patología, y la refractariedad en el tratamiento de los trastornos psiquiátricos cuando existe esta comorbilidad. Aunque no se encuentra mayor evidencia que relacione los trastornos psiquiátricos con la apnea obstructiva del sueño, existen algunos datos que relacionan los trastornos depresivos y síntomas ansiosos, con comorbilidad de apnea del sueño, lo que alerta sobre la búsqueda activa de ambas condiciones en los pacientes con uno de los diagnósticos. Conclusiones: El médico debe sospechar apnea obstructiva del sueño en pacientes con depresión refractaria principalmente, ronquido crónico, cuello corto y ancho, un elevado índice de masa corporal y somnolencia diurna excesiva.
