Determinants and impact of alexithymia on quality of life in Parkinson's disease.

INTRODUCTION: Alexithymia is a neuropsychiatric symptom conceptualized as difficulty identifying and describing feelings. Although associated with other non-motor symptoms, mainly neuropsychiatric, alexithymia may present as an isolated symptom in persons with Parkinson's Disease (PwP). The objective of the study is to identify determinants of alexithymia and its association with quality of life (QoL) in Parkinson's disease. METHODS: Subjects with Parkinson's disease were recruited. The following instruments were applied: Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment (MoCA), Toronto alexithymia scale (TAS-20) and Parkinson's Disease Questionnaire (PDQ-8). Matched healthy controls were screened using TAS-20. Clinical and demographical variables were compared between alexithymic and non-alexithymic. Regression models were used to find determinants of alexithymia. Impact of alexithymia on QoL was estimated with a linear regression model. RESULTS: 98 patients were included. 56.1% PwP and 28.8% controls were alexithymic (p<0.001). Education level (OR 0.86) and NMSS urinary score (OR 1.09) determined alexithymia as well as TAS-20 score. Alexithymia was an independent determinant of QoL. CONCLUSIONS: Alexithymia is a prevalent independent non-motor symptom in PwP with impact on QoL. Low education level and urinary symptoms are important determinants of alexithymia.

Determinants and impact of alexithymia on quality of life in Parkinson’s disease / Determinantes e impacto de la alexitimia en la calidad de vida en la enfermedad de Parkinson

Introduction: Alexithymia is a neuropsychiatric symptom conceptualized as difficulty iden-tifying and describing feelings. Although associated with other non-motor symptoms, mainlyneuropsychiatric, alexithymia may present as an isolated symptom in persons with Parkinson’sDisease (PwP). The objective of the study is to identify determinants of alexithymia and itsassociation with quality of life (QoL) in Parkinson’s disease. Methods: Subjects with Parkinson’s disease were recruited. The following instruments wereapplied: Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS),Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment (MoCA), Toronto alexithymiascale (TAS-20) and Parkinson’s Disease Questionnaire (PDQ-8). Matched healthy controls werescreened using TAS-20. Clinical and demographical variables were compared between alex-ithymic and non-alexithymic. Regression models were used to find determinants of alexithymia.Impact of alexithymia on QoL was estimated with a linear regression model.Results: 98 patients were included. 56.1% PwP and 28.8% controls were alexithymic (p < 0.001).Education level (OR 0.86) and NMSS urinary score (OR 1.09) determined alexithymia as well asTAS-20 score. Alexithymia was an independent determinant of QoL. Conclusions: Alexithymia is a prevalent independent non-motor symptom in PwP with impacton QoL. Low education level and urinary symptoms are important determinants of alexithymia.(AU)

Introducción: La alexitimia es un rasgo neuropsiquiátrico conceptualizado como la dificul-tad para identificar y describir sentimientos. Aunque está asociado con otros síntomas nomotores, principalmente neuropsiquiátricos, sigue siendo una característica independiente delas personas con enfermedad de Parkinson (PcP). El objetivo del estudio es identificar losdeterminantes de la alexitimia y su asociación con la calidad de vida en la enfermedad deParkinson. Métodos: Se reclutaron sujetos con enfermedad de Parkinson. Se aplicaron los siguientesinstrumentos: escala unificada de la enfermedad de Parkinson de la Sociedad de Trastornosdel Movimiento (MDS-UPDRS), escala de síntomas no motores (NMSS), evaluación cognitiva deMontreal (MoCA), escala de alexitimia de Toronto (TAS-20) y cuestionario de la enfermedadde Parkinson (PDQ-8). Se incluyeron controles sanos pareados, los cuales se evaluaron usandola TAS-20. Las variables clínicas y demográficas se compararon entre pacientes alexitímicos yno alexitímicos. Se utilizaron modelos de regresión para estimar los predictores de alexitimia.El impacto de este rasgo neuropsiquiátrico en la calidad de vida se estimó con un modelo deregresión lineal. Resultados: Se incluyeron 98 pacientes. El 56,1% de PcP y el 28,8% de los controles fueronalexitímicos (p < 0,001). El nivel educativo (OR 0,86) y la puntuación urinaria del NMSS (OR1,09) determinaron la alexitimia, así como la puntuación del TAS-20. La alexitimia fue undeterminante independiente de calidad de vida. Conclusiones: La alexitimia es un síntoma independiente no motor prevalente con impactoen la calidad de vida. El bajo nivel educativo y los síntomas urinarios son determinantesimportantes de esta condición. (AU)

Práctica de Enfermería para control emocional en personas con antecedentes de infarto agudo de miocardio / Nursing practice for emotional control in people with a history of acute myocardial infarction

RESUMEN El ejercicio de la Enfermería tiene un alto componente de responsabilidad y comportamiento ético para el control emocional de las personas con antecedentes de infarto agudo de miocardio. Este sustento le da significado a la práctica de la Enfermería para ser aplicada de forma sistemática y organizada. Se realizó una investigación descriptiva con el objetivo de proponer acciones, desde la Enfermería, que contribuyan al mejoramiento del control emocional en las personas con antecedentes de infarto agudo de miocardio pertenecientes al Policlínico Docente Universitario «Martha Abreu de Estévez¼, de Santa Clara, Villa Clara, en el período de enero de 2017 a febrero de 2019. En las personas estudiadas se constató un predominio de: autoestima baja, alta vulnerabilidad al estrés y la ansiedad. Por otro lado, se evidenciaron dificultades en el conocimiento de sus estados emocionales, incapacidad para clarificar y reparar sus emociones, así como una satisfacción vital no satisfactoria.

ABSTRACT Nursing practice has a high component of responsibility and ethical behavior for the emotional control of people with a history of acute myocardial infarction. This support gives meaning to the practice of Nursing to be applied in a systematic and organized way. A descriptive research was carried out with the objective of proposing actions, from the point of view of Nursing, that contribute to the improvement of emotional control in people with a history of acute myocardial infarction belonging to "Martha Abreu de Estévez" University Teaching Polyclinic, in Santa Clara, Villa Clara, from January 2017 to February 2019. A predominance of low self-esteem, high vulnerability to stress and anxiety was found in the people studied. On the other hand, difficulties in understanding their emotional states, inability to clarify and repair their emotions, as well as unsatisfactory life satisfaction were evidenced.

Las prácticas de integración cuerpo-mente como promotoras de estados emocionales saludables / Mind­Body Integration Practices as Promoters of Healthy Emotional States / Práticas de integração corpo-mente como promotoras de estados emocionais saudáveis

Recientes investigaciones provenientes de diversos campos emergentes como la psiconeu-roinmunología, la medicina integrativa o la pigenética han dado cuenta de la estrecha vinculación entre los estados emocionales y la salud. El objetivo fue evaluar la eficacia de una intervención basada en la realización de prácticas de integración cuerpo-mente sobre la regulación emocional. Materiales y métodos: en 102 participantes, de entre 34 y 65 años de edad, se analizaron cambios en la Escala de Afectividad Positiva y Negativa (panas), antes y después de participar en la intervención propuesta, que se realizó durante ocho encuentros de seis horas de duración cada uno, a lo largo de cuatro meses. Resultados: se encontró un aumento en la afectividad positiva y una disminución en la afectividad negativa luego de la intervención. El índice de afectividad (i. e. afectividad positiva/afectividad negativa) se incrementó de una relación 2:1 a una relación 3:1. Esta última proporción ha sido asociada con estados saludables. Conclusiones: el estudio contribuye a demostrar el beneficio que brindan las prácticas de integración cuerpo-mente en la regulación emocional y la afectividad positiva. Esto podría propiciar un mayor bienestar psicofísico individual y colectivo.

Recent research from various emerging fields, such as psychoneuroimmunology, integra-tive medicine, and epigenetics, showed a close link between emotional states and health. This study was designed to evaluate the effectiveness of an intervention based on mind­body integration practices in emotional regulation. Materials and Methods: We evaluated changes in the positive and negative affectivity scale in 102 participants before and after the intervention, which was performed during eight meetings lasting 6 h each, for 4 months. Results: An increase in positive affectivity and a decrease in negative affectivity were found after the intervention. The affectivity index (i.e., positive affectivity/negative affectivity) increased from a 2:1 ratio to a 3:1 ratio. This latter ratio has been associated with healthy states. Conclusions: This study demonstrated that mind­body integration practices can confer to emotional regulation and positive affectivity. These beneficial effects could improve psychophysical well-being at both the individual and collective levels.

pesquisas recentes provenientes de vários campos emergentes, como a psiconeuroimuno-logia, medicina integrativa e epigenética, mostram a estreita ligação entre os estados emocionais e a saúde. O objetivo do presente trabalho é avaliar a eficácia de uma intervenção baseada na realização de práticas de integração corpo-mente, na regulação emocional. Materiais e métodos: em 102 participantes, entre 34 e 65 anos, foram analisadas as mudanças na escala de afetividade positiva e negativa (panas) antes e após a participação na intervenção proposta, que foi realizada durante 8 encontros de 6 horas de duração cada, durante 4 meses. Resultados: houve um aumento da afetividade positiva e diminuição da afetividade negativa após a intervenção. O índice de afetividade (ou seja, afetividade positiva/afetivi-dade negativa) aumentou, passando de uma relação de 2:1 para uma relação de 3:1, esta última propor-ção tem sido associada a estados saudáveis. Conclusões: o presente estudo contribui para demonstrar o benefício proporcionado pelas práticas de integração corpo-mente na regulação emocional e na afetivi-dade positiva. Isso poderia propiciar um maior bem-estar psicofísico a nível individual e coletivo.

Implementation of a multi-family intervention for children with behavioural and emotional problems in a semi-rural population.

OBJECTIVE: To determine the feasibility of implementing a community-based, multi-family group intervention in a semi-rural population in Aranzazu, northern Caldas, Colombia. METHODS: Qualitative study. A convenience sample was taken of 10 families with children with affective and behavioural disorders, previously identified by the Child Behaviour Checklist (CBCL). The Multifamily Psychoeducational Psychotherapy (MF-PEP) model was adapted to the culture and needs of the families. RESULTS: The contents of the sessions and the topics and experiences that were most significant for the children and their families are described. CONCLUSIONS: The adaptation to the cultural context of the multi-family intervention had a very good acceptability by all participants: caregivers, children and therapists.

Implementación de una intervención multifamiliar para niños con problemas conductuales y emocionales en una población semirrural / Implementation of a Multi-Family Intervention for Children With Behavioural and Emotional Problems in a Semi-Rural Population

RESUMEN Objetivo: Determinar la factibilidad de implementar una intervención grupal multifamiliar, basada en la comunidad, en una población semirrural en Aranzazu, en el norte de Caldas, Colombia. Métodos: Estudio cualitativo. Se tomó una muestra de conveniencia de 10 familias con ninos con alteraciones afectivas y conductuales, previamente identificados mediante la Child Beha-vior Checklist (CBCL). Se adaptó a la cultura y a las necesidades de las familias el modelo de Psicoterapia Psicoeducativa Multifamiliar (MF-PEP). Resultados: Se describen los contenidos de las sesiones, los temas y las experiencias que fueron más significativos para los ninos y sus familias. Conclusiones: La adecuación al contexto cultural de la intervención multifamiliar tuvo una muy buena aceptación de los participantes, tanto cuidadores como ninos y terapeutas.

ABSTRACT Objective: To determine the feasibility of implementing a community-based, multi-family Multiple psychotherapy group intervention in a semi-rural population in Aranzazu, northern Caldas, Colombia. Family Affective symptoms Methods: Qualitative study. A convenience sample was taken of 10 families with children Child with affective and behavioural disorders, previously identified by the Child Behaviour Check-Community list (CBCL). The Multifamily Psychoeducational Psychotherapy (MF-PEP) model was adapted to the culture and needs of the families. Results: The contents of the sessions and the topics and experiences that were most significant for the children and their families are described. Conclusions: The adaptation to the cultural context of the multi-family intervention had a very good acceptability by all participants: caregivers, children and therapists.

Smoking and loneliness in older adults: a population-based study in Campinas, São Paulo State, Brazil / Tabagismo e solidão em idosos: um estudo de base populacional em Campinas, São Paulo, Brasil / Tabaquismo y soledad en adultos mayores: un estudio basado en población de Campinas, estado de São Paulo, Brasil

This study aims to analyze the relationship between social isolation and loneliness with smoking in older adults. This is a cross-sectional, population-based study performed with 986 individuals aged 60 years or older. Data were collected from the Health Survey of the Municipality of Campinas (ISACamp 2014/2015), state of São Paulo, Brazil. We estimated the prevalence of smoking and smoking cessation according to independent variables and tested the associations using the chi-square test, considering a 5% significance level. Adjusted prevalence ratios were calculated using simple and multiple Poisson regression. Smoking and smoking cessation were not associated with most variables that indicate objective social isolation. "Often or always" loneliness was related to a higher prevalence of smoking (PR = 2.25; 95%CI: 1.38-3.66) whereas loneliness accompanied of self-reported emotional problems or common mental disorders was strongly associated with smoking and with lower smoking cessation (PR = 6.24; 95%CI: 1.37-28.47 and PR = 0.46; 95%CI: 0.28-0.77, respectively). These findings indicate that loneliness is a psychosocial aspect related to tobacco use which hinders smoking cessation in older adults, emphasizing the importance of emotional problems in this association.

O estudo busca analisar a relação entre isolamento social, solidão e tabagismo entre idosos. Trata-se de um estudo transversal de base populacional que incluiu 986 indivíduos com 60 anos ou mais. Os dados foram obtidos do Inquérito de Saúde de Município de Campinas (ISACamp 2014/2015), São Paulo, Brasil. Foram estimadas as taxas de prevalência do tabagismo e da cessação do tabagismo de acordo com as variáveis independentes e testadas as associações através do teste de qui-quadrado, considerando nível de significância de 5%. Foram calculadas as razões de prevalência ajustadas com o uso de regressão de Poisson simples e múltipla. O tabagismo e a cessação do tabagismo não mostraram associação com a maioria das variáveis que indicam isolamento social objetivo, enquanto o relato da solidão muitas vezes ou sempre esteve relacionado a uma maior prevalência de tabagismo (RP = 2,25; IC95%: 1,38-3,66). A solidão, acompanhada pelo autorrelato de problemas emocionais ou a presença de transtornos mentais comuns, esteve fortemente associada com o tabagismo e com menor prevalência de cessação do tabagismo (RP = 6,24; IC95%: 1,37-28,47 e RP = 0,46; IC95%: 0,28-0,77, respectivamente). Os achados sustentam o papel da solidão enquanto aspecto psicossocial relacionado ao uso de tabaco e ao impedimento da cessação do tabagismo em idosos e destacam a importância de problemas emocionais nessa associação.

El objetivo de este estudio fue analizar la relación entre el aislamiento social y la soledad con el hábito de fumar en adultos mayores. Se trata de un estudio transversal basado en población, realizado con 986 individuos con 60 años o mayores. Los datos se recogieron de la Encuesta de Salud de la Ciudad de Campinas (ISACamp 2014/2015), estado de São Paulo, Brasil. Estimamos la prevalencia del hábito de fumar y dejar de fumar según variables independientes y probamos las asociaciones usando el test chi-cuadrado, considerando un nivel de significancia de un 5%. Se calcularon las ratios de prevalencia usando una regresión simple y múltiple de Poisson. Fumar y dejar de fumar no estuvieron asociadas con la mayor parte de variables que indican aislamiento social objetivo, mientras que informar soledad a menudo o siempre estuvo relacionado con una más alta prevalencia de tabaquismo (RP = 2,25; IC95%: 1,38-3,66). Soledad acompañada de problemas emocionales autoinformados o la presencia de desórdenes mentales comunes estuvo fuertemente asociado con el tabaquismo y con una menor prevalencia de dejar de fumar (RP = 6,24; IC95%: 1,37-28,47 y RP = 0,46; IC95%: 0,28-0,77, respectivamente). Estos resultados apoyan el papel de la soledad como un aspecto psicosocial relacionado con el consumo de tabaco y el impedimento de dejar de fumar en adultos mayores, además de subrayar la importancia de problemas emocionales en esta asociación.

Relación entre el sexo y los síntomas motores y no motores en pacientes con Parkinson / Relationship between sex and motor and non - motor symptoms in Parkinson's patients

Introducción: La enfermedad de Parkinson es una entidad neurodegenerativa caracterizada por bradicinesia, temblor en reposo y rigidez. Objetivo: Determinar la relación entre el sexo y los síntomas motores y no motores en pacientes con enfermedad de Parkinson. Métodos: Se realizó un estudio observacional analítico transversal sobre la relación entre el sexo y los síntomas motores y no motores en pacientes con enfermedad de Parkinson en el Hospital Clínico Quirúrgico Lucía Íñiguez Landín en el año 2018. El universo estuvo constituido por los 675 pacientes con Parkinson atendidos en consulta. La muestra fue de 110 pacientes. Resultados: Predominó el grupo etario 60-69 años (34,55 por ciento). Los síntomas no motores al inicio de la enfermedad fueron mayores para un 68,18 por ciento. Dentro de los síntomas motores, prevalecieron el temblor (80 por ciento) y la rigidez (72,72 por ciento). El síntoma más prevalente en el sexo masculino fue el temblor y en el femenino la rigidez. Dentro de los síntomas no motores destacaron los trastornos del sueño para un 92,72 por ciento y alteraciones neuropsiquiátricas para un 86,36 por ciento. Conclusiones: En el presente estudio se encontraron diferencias significativas entre hombres y mujeres en la prevalencia de algunos síntomas motores y no motores(AU)

Introduction: Parkinson's disease is a neurodegenerative entity characterized by bradykinesia, tremor at rest and rigidity. Objective: To determine the relationship between sex and motor and non-motor symptoms in patients with Parkinson's disease. Methods: A cross-sectional analytical observational study was carried out on the relationship between sex and motor and non-motor symptoms in patients with Parkinson's disease at Lucía Íñiguez Landín Clinical Surgical Hospital in 2018. The universe consisted of 675 Parkinson's patients seen in consultation. The sample consisted of 110 patients. Results: The age group 60-69 years (34.55percent) predominated. Non-motor symptoms predominated at the beginning of the disease in 68.18percent. Tremor (80percent) and rigidity (72.72percent) predominated within the motor symptoms. The most prevalent symptom in males was tremor and rigidity in females. While as the non-motor symptoms, sleep disorders predominated in 92.72percent and neuropsychiatric disorders in 86.36percent. Conclusions: In the present study, significant differences were found between men and women in the prevalence of some motor and non-motor symptoms(AU)

Síntomas depresivos en adultos peruanos: un análisis de redes

RESUMEN Introducción: las personas que experimentan síntomas depresivos generalmente informan problemas emocionales y físicos que complican su estado de salud. Los esfuerzos de prevención son necesarios para un tratamiento temprano y resulta relevante identificar qué síntomas son más importantes para las estrategias de prevención e intervención en población general. Objetivo: analizar la interrelación y síntomas depresivos centrales en una población general de adultos peruanos mediante el análisis de redes. Metodología: participaron 275 adultos peruanos que fueron evaluados con el Patient Health Questionnaire-9. Se estimó una estructura de red transversal de correlación parcial regularizada. Específicamente se analizó el índice de centralidad de fuerza, predictibilidad, estabilidad y pruebas de diferencias de los pesos de bordes y fuerza. Este estudio respetó los aspectos éticos, como la confidencialidad de la información, el anonimato y el consentimiento informado. Resultados: se evidenció que todos los nodos de la estructura de red se asociaron positivamente, donde los pensamientos de muerte se relacionaron con los problemas psicomotores, sentimientos de inutilidad y cambios en el apetito. La predictibilidad media fue de 30% y los síntomas depresivos más centrales fueron los pensamientos de muerte y las dificultades de concentración. La estimación de la fuerza fue estable (0,59) y las pruebas post-hoc mostraron diferencias significativas en los pesos de los bordes y fuerza. Conclusiones: los hallazgos del estudio sugieren que los pensamientos de muerte y las dificultades de concentración desempeñan un papel importante en la estructura de red en población general de adultos peruanos. Por lo tanto, estos síntomas podrían ayudar a los profesionales de la salud a identificar a las personas más vulnerables a desarrollar síntomas depresivos y, en consecuencia, pueden ser objetivos importantes de pronóstico, intervención y estrategias de prevención en la atención primaria de salud mental.

ABSTRACT Introduction: People who experience depressive symptoms, generally inform emotional and physical problems that complicate their state health. Prevention efforts are necessary for early intervention and it is relevant to identify the most important symptoms for prevention and intervention strategies in the general population. Objective: To analyze the interrelation and central depressive symptoms in the general population of Peruvian adults by means of a network analysis. Methodology: Two hundred seventy-five Peruvian adults participated and were evaluated with the Patient Health Questionnaire-9. A regularized partial correlation cross-sectional network structure was estimated. Specifically, the force centrality index, predictability, stability and tests of differences of the edge weights and force were analyzed. This study respected ethical aspects, such as confidentiality of information, anonymity and informed consent. Results: It was evidenced that all nodes of the network structure were positively associated, where thoughts of death were associated with psychomotor problems, feelings of worthlessness and changes in appetite. The mean predictability was 30% and the most common central depressive symptoms were thoughts of death and concentration difficulties. The force estimate was stable (0.59) and the post-hoc tests showed significant differences in the edge weights and force. Conclusions: The study findings suggest that thoughts of death and concentration difficulties perform an important role in the network structure in the Peruvian general adult population. Hence, these symptoms could help health professionals to identify the most vulnerable people to develop depressive symptoms and, consequently, they can be important targets for prognosis, intervention, and prevention strategies in primary mental health care.

Síntomas afectivos en profesionales que laboran en la atención a casos positivos de COVID-19 / Affective symptoms in professionals who work in the positive COVID-19 cases care

RESUMEN Fundamento La COVID-19 implica retos específicos para los trabajadores de la salud, los cuales representan una mayor carga de estrés. Ello confiere interés y relevancia al estudio de la esfera afectiva en este sector, protagonista en la atención a pacientes positivos de COVID-19. Objetivo caracterizar síntomas afectivos en profesionales que laboran en la atención a casos positivos de COVID-19. Métodos se realizó un estudio descriptivo transversal, en profesionales de la salud que laboran en la atención a pacientes positivos a la COVID-19; enmarcado entre los meses de abril y julio del 2020, en el hospital Manuel Fajardo Rivero de Santa Clara. La población de estudio fueron 82 trabajadores (enfermeros y tecnólogos de la Salud). Las variables estudiadas fueron sexo, categoría profesional y rango de severidad de los síntomas afectivos (depresión y ansiedad). Resultados la totalidad de los profesionales presentó algún grado de ansiedad, con predominio de la forma moderada (64,6 %). El 63,4 % no manifestó depresión, sin embargo, el 43,47 % de los que tuvieron este síntoma fueron mujeres, y el 52,63 % enfermeros de profesión. La ansiedad en forma moderada afectó al 72,22 % de los hombres, 58,69 % de las mujeres, y el 68,42 % de los enfermeros. Conclusión Entre los síntomas afectivos en profesionales que laboran en la atención de casos positivos a la COVID 19 se observó un predominio de la ansiedad. Este estudio explora aspectos de la salud mental que avizoran sobre la importancia de intervenciones futuras.

ABSTRACT Background COVID-19 involves specific challenges for healthcare workers, which represent a greater burden of stress. This confers interest and relevance to the study of the affective sphere in this sector, a protagonist in the positive COVID-19 patient's care. Objective to characterize affective symptoms in professionals who work in the positive COVID-19 cases care. Methods a cross-sectional descriptive study was carried out in health professionals who work in the positive COVID-19 patient's care; between April and July 2020, at the Manuel Fajardo Rivero hospital in Santa Clara. 82 workers (nurses and health technologists) were the study population. The variables studied were sex, professional category and range of severity of affective symptoms (depression and anxiety). Results all the professionals presented some degree of anxiety, with a predominance of the moderate form (64.6%). The 63.4% did not show depression, however, 43.47% of those who had this symptom were women, and 52.63% were professional nurses. Anxiety moderately affected 72.22% of men, 58.69% of women, and 68.42% of nurses. Conclusion Among the affective symptoms in professionals who work in the positive COVID 19 cases care, a predominance of anxiety was observed. This study explores aspects of mental health that foresee the importance of future interventions.

Agotamiento Emocional en estudiantes universitarios del área de la salud / Emotional exhaustion in university students within the health field

Resumen Introducción: El Agotamiento Emocional (AE) es la disminución de energía, sentimiento de desgaste emocional y físico, asociados a una sensación de frustración y fracaso. Los estudiantes universitarios experimentan situaciones que conjugan diversos elementos estresores. Objetivo: Describir el AE en estudiantes universitarios del área de la salud en instituciones de educación superior (IES) de la ciudad de Bucaramanga - Colombia. Materiales y métodos: Estudio cualitativo que siguió un diseño flexible de tipo descriptivo interpretativo, articulado al análisis de contenido. Se realizaron 175 entrevistas abiertas de forma consentida y voluntaria. Resultados: Se encontraron tres categorías con sus respectivas subcategorías: agotamiento emocional (consecuencias fisiológicas y psicológicas), dificultades asociadas (académicas, socio-familiares), estrategias de afrontamiento (activas y resolutivas, pasivas y negativas). Conclusiones: Los estudiantes experimentan el AE, hecho que repercute en su salud física y mental, disminución del desempeño académico y afectación en la vida familiar y social. Las estrategias de afrontamiento para algunos de ellos, son de carácter resolutivo, mientras que para otros son de tipo negativo. El AE puede ser mitigado con estrategias de prevención y apoyo psicosocial.

Abstract Introduction: Emotional exhaustion (EE) is a state of emotional and physical burnout and energy depletion that are associated with feelings of frustration and failure. University students experience situations that combine various stressful elements. Objective: To describe EE health field students from universities of the city of Bucaramanga - Colombia. Materials and methods: A qualitative study with a flexible, descriptive and interpretative design was carried out, which included 175 open interviews conducted in a consensual and voluntary manner. Results: Three categories and respective subcategories were revealed: (i) emotional exhaustion (physiological and psychological consequences); (ii) associated difficulties (academic, social and familiar); and (iii) coping strategies (active and decisive or passive and negative). Conclusions: Students experience EE, which affects their physical and mental health, decreases their academic performance and disturbs their familiar and social interactions. Some students apply decisive coping strategies, while others use negative ones. EE can be mitigated through prevention strategies and psychosocial support.

Análise das qualidades psicométricas da versão portuguesa do Inventário de Avaliação da Espontaneidade (SAI-R) / Analysis of the psychometric qualities of the portuguese version of the Spontaneity Assessment Inventory (SAI-R) / Análisis de las cualidades psicométricas de la versión portuguesa del Inventario de Evaluación de la Espontaneidad (SAI-R)

A espontaneidade e as suas ligações à saúde mental e ao bem-estar são uma componente central quer na teoria quer na prática do psicodrama, e a literatura especializada associa a presença de patologia à falta de espontaneidade. Neste artigo, elencam-se alguns dos resultados obtidos em estudos em língua inglesa do SAI-R e apresentam-se os estudos da sua validação para a população portuguesa. Na validação do SAI-R para o contexto português, foi confirmada a estrutura fatorial com 719 sujeitos, distribuídos em duas amostras independentes. Os participantes tinham idades entre os 18 e os 69 anos. Por fim, foram testadas a fiabilidade compósita e a validade convergente, bem como a validade do tipo critério em duas amostras independentes (n 1ªamostra =348 e n 2ªamostra =371). Apesar de serem necessários mais estudos com populações clínicas, o SAI-R apresenta-se como um instrumento curto e válido para aplicar em contextos clínicos e não clínicos quando se pretende avaliar a espontaneidade (AU).

Spontaneity and its connections to mental health and wellbeing are a central theme in both the theory and practice of psychodrama, and the specialized literature sometimes even associates the presence of pathology with a lack of spontaneity. In this article, we list some of the results obtained in studies with the English-language version of the spontaneity scale and present its validation studies for the Portuguese population. We verified a factorial structure with 719 subjects, divided into two independent samples in the validation of the SAI-R for the Portuguese context. Participants had an age range of 18 to 69 years old. Furthermore, composite reliability, convergent validity, and cross validity were tested in two other independent samples (n sample1 =348 and n sample2 =371). Although further studies with clinical samples are needed, the SAI-R presents itself as a short and valid instrument to apply in clinical and non-clinical settings when assessing spontaneity (AU).

La espontaneidad y sus vínculos con la salud mental y el bienestar son una componente central tanto en la teoría como en la práctica del psicodrama, y la literatura especializada asocia la presencia de patología con la falta de espontaneidad. En este artículo se enumeran resultados obtenidos con la versión inglesa del SAI-R y se presentan estudios para su aplicación en la población portuguesa. En la validación del SAI-R para el contexto portugués, se confirmó la estructura factorial con 719 sujetos, distribuidos en dos muestras independientes. Los participantes tenían entre 18 y 69 años. Finalmente, se probaron la confiabilidad compuesta y la validez convergente, así como la validez cruzada en las dos muestras independientes (n muestra 1 = 348 y n muestra2 = 371). Aunque son necesarios más estudios con poblaciones clínicas, el SAI-R se presenta como un instrumento breve y válido para ser aplicado en contextos clínicos y no clínicos en la evaluación de la espontaneidad (AU).

Síntomas depresivos en pacientes diagnosticados con COVID-19 en Pinar del Río / Depressive symptoms in patients diagnosed with COVID-19 in Pinar del Rio province

RESUMEN Introducción: la pandemia por la COVID-19 trae como consecuencia un aumento en el número de casos confirmados y muertes en el mundo. Esta situación provoca el desarrollo de emociones y pensamientos negativos que interfieren en el bienestar y en la salud mental. Objetivo: evaluar síntomas depresivos en pacientes diagnosticados con COVID-19, ingresados en el Hospital Provincial Clínico Quirúrgico Docente Dr. León Cuervo Rubio de Pinar del Río, en los meses de abril a junio en el año 2020. Métodos: se realizó un estudio observacional, descriptivo de corte transversal, en pacientes institucionalizados con diagnóstico de COVID-19 para evaluar síntomas depresivos en el periodo de actividad de la enfermedad durante el año 2020, en un universo de 37 pacientes, en enfermos con edades de 20 años y más. Resultados: en la población estudiada existió un predominio del 50 % del sexo femenino en edades entre 40-59 años, de ellos 34 pacientes presentaron humor depresivo para un 91,89 %, seguido de disminución de su vitalidad 86,48 % y pérdida de la atención y concentración. Dentro de las enfermedades crónicas no transmisibles que presentaron mayor presencia de síntomas depresivos se encontraron la hipertensión arterial y el asma bronquial. Conclusiones: la investigación ha demostrado que la percepción de enfermedades infecciosas referida por la población objeto de estudio, se expresa en una mayor prevalencia de síntomas depresivos. Se destacan el humor depresivo, disminución de su vitalidad, esto repercute en el estado físico y emocional del paciente.

ABSTRACT Introduction: COVID-19 pandemic is resulting in an increase in the number of confirmed positive cases and deaths worldwide. This situation causes the development of negative emotions and thoughts that interfere with well-being and mental health. Objective: to evaluate depressive symptoms in patients diagnosed with COVID-19 admitted to Dr. León Cuervo Rubio Provincial Clinical-Surgical-Teaching Hospital in Pinar del Río province, from April to June 2020. Methods: an observational, descriptive and cross-sectional study was conducted with institutionalized patients diagnosed with COVID-19 to evaluate the depressive symptoms in the period of activity of COVID-19 during the year 2020, with a target group comprising 37 patients who were 20 years and older. Results: the population studied presented a predominance of 50 % of female patients (40-59 years old), where 34 of them showed depressive mood (91,89 %), followed by a decrease in vitality 86,48 % and loss of attention and concentration. Among the chronic non-communicable diseases they suffered from, there was a greater presence of depressive symptoms in patients with hypertension and bronchial asthma. Conclusions: the research has shown that the perception of infectious diseases referred by the population under study evidenced a higher prevalence of depressive symptoms. Depressive mood and decreased vitality stand out, having repercussions on the physical and emotional status of the patients.

Determinants and impact of alexithymia on quality of life in Parkinson's disease.

INTRODUCTION: Alexithymia is a neuropsychiatric symptom conceptualized as difficulty identifying and describing feelings. Although associated with other non-motor symptoms, mainly neuropsychiatric, alexithymia may present as an isolated symptom in persons with Parkinson's Disease (PwP). The objective of the study is to identify determinants of alexithymia and its association with quality of life (QoL) in Parkinson's disease. METHODS: Subjects with Parkinson's disease were recruited. The following instruments were applied: Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment (MoCA), Toronto alexithymia scale (TAS-20) and Parkinson's Disease Questionnaire (PDQ-8). Matched healthy controls were screened using TAS-20. Clinical and demographical variables were compared between alexithymic and non-alexithymic. Regression models were used to find determinants of alexithymia. Impact of alexithymia on QoL was estimated with a linear regression model. RESULTS: 98 patients were included. 56.1% PwP and 28.8% controls were alexithymic (p<0.001). Education level (OR 0.86) and NMSS urinary score (OR 1.09) determined alexithymia as well as TAS-20 score. Alexithymia was an independent determinant of QoL. CONCLUSIONS: Alexithymia is a prevalent independent non-motor symptom in PwP with impact on QoL. Low education level and urinary symptoms are important determinants of alexithymia.

Implementation of a Multi-Family Intervention for Children With Behavioural and Emotional Problems in a Semi-Rural Population. / Implementación de una intervención multifamiliar para niños con problemas conductuales y emocionales en una población semirrural.

OBJECTIVE: To determine the feasibility of implementing a community-based, multi-family group intervention in a semi-rural population in Aranzazu, northern Caldas, Colombia. METHODS: Qualitative study. A convenience sample was taken of 10 families with children with affective and behavioural disorders, previously identified by the Child Behaviour Checklist (CBCL). The Multifamily Psychoeducational Psychotherapy (MF-PEP) model was adapted to the culture and needs of the families. RESULTS: The contents of the sessions and the topics and experiences that were most significant for the children and their families are described. CONCLUSIONS: The adaptation to the cultural context of the multi-family intervention had a very good acceptability by all participants: caregivers, children and therapists.

[Identification of behavioural and emotional problems in premature children in the primary care setting]. / Identificación de problemas de conducta y emocionales en niños prematuros en el ámbito de atención primaria.

OBJECTIVE: To demonstrate the usefulness, for use by the primary care pediatrician, of the BASC questionnaire (Behavior Assessment System for Children) for the early detection of psychological and behavioral problems in premature infants. DESIGN: Cross-sectional and descriptive study. SETTING: Primary care (Health Area IV of the Principado of Asturias) and Hospital Universitario Central de Asturias, Spain. PARTICIPANTS: Parents of 87 premature children with birth weight less than 1500g and 43 full-term controls, both aged 5-7 years. MAIN MEASUREMENTS: The BASC questionnaire (parent version) was applied. RESULTS: Preterm children presented a high rate of inactivity (Z = -4.125, P < 0.001), anxiety (Z = -2.801, P = 0.005) and internalization problems (Z = -2.148, P = 0.032), being more evident at 5 years of age. Preterm boys show higher levels of hyperactivity (Z = -2.082, P = 0.037) and behavioural problems (Z = -2.354, P = 0.019) than girls, who presented more attentional problems (Z = -2.345; P = 0.019). CONCLUSIONS: The BASC questionnaire is useful for the detection and early diagnosis at the primary care level of the behavioral and emotional problems of premature children.

Diabetes Summer Camp in children and adolescents with type 1 diabetes: Effects on well-being and quality of life.

OBJETIVE: The aim of this study was to examine the quality of life, anxiety and affectivity in children and adolescents with type 1 diabetes (T1D) and in their parents after participating in a diabetes summer camp. METHOD: A total of 20 children and adolescents with T1D, aged 8-14, and their parents participated. The study design was quasi-experimental longitudinal with an intra-subject factor with two measurements (pre/post), and an inter-group factor (child/parent). RESULTS: After attending camp, a significantly increased quality of life, demonstrated by the emotional well-being and self-esteem scores, was found in the children but not in the parents. Less negative affectivity and an improvement in positive affectivity was seen in the parents, but not in the children. Differences in anxiety were found in both the children and the parents. CONCLUSIONS: This research presents empirical evidence of the benefits of participation in a diabetes camp in both children and their parents.

Asociación entre hipotiroidismo y diagnóstico psiquiátrico en una Unidad Técnica de un hospital de tercer nive / Association between hypothyroidism and psychiatric diagnosis in a Technical Unit of a third-level hospital

INTRODUCCIÓN. La relación entre el eje tiroideo y las patologías psiquiátricas, ha sido tema de amplio estudio, siendo la de mayor interés los trastornos afectivos y el hipotiroidismo. No solo la similitud de los síntomas que presentan las patologías, sino también la terapéutica esta-blecida, son argumentos a favor de la existencia de una relación significativa. A pesar de esto, la información de la que se dispone de estudios realizados es dividida. OBJETIVO. Describir la influencia del hipotiroidismo en el tipo de diagnóstico psiquiátrico y características clínicas en pacientes hospitalizados en la Unidad Técnica de Salud Mental. MATERIALES Y MÉTODOS. Estudio descriptivo y retrospectivo con una población de 678 pacientes y, muestra de 472, los criterios de inclusión fueron: mayores a 18 años: adultos de mediana edad de 18 a 64 y adultos mayores de 65 años, con diagnóstico definitivo de egreso acorde a la Clasificación Internacional de Enfermedades - 10 de trastornos mentales y del comportamiento; muestra subcategorizada en trastornos: 259 afectivos, 131 psicóticos, 44 por consumo de sustancias y 38 ansiosos; y, en los que se investigó hipotiroidismo, estuvieron hospitalizados y atendidos en la Unidad Técnica de Salud Mental del Hospital de Especialidades Carlos Andrade Marín, durante los años 2014 y 2015. Los datos fueron analizados con el programa estadístico International Business Machines Statistical Package for the Social Sciences, Versión 22.0. RESULTADOS. El 51,50% (243; 472) fueron de sexo masculino; el 90% (425; 472) fueron adultos de mediana edad; 54,9% (259; 472) fueron trastornos afectivos; 18,4% (87; 472) fueron pacientes hipotiroideos con diagnóstico defini-tivo de egreso de trastornos mentales y del comportamiento que correspondieron a los mayores de 65 años. Trastornos afectivos 19,7% (51; 259), psicóticos 16,8% (22; 131), por consumo de sustancias 13,6% (6; 44) y ansiosos 21,1% (8; 38). CONCLUSIÓN. Se evidenció una relación significativa entre hipotiroidismo y trastornos mentales y del comportamiento sobre todo del tipo afectivo en adultos mayores.

INTRODUCTION. The relationship between the thyroid axis and psychiatric pathologies has been the subject of extensive study, with affective disorders and hypothyroidism. Being of greatest inte-rest. Not only the similarity of the symptoms presented by the patologies,, but also the established therapeutic, are arguments in favor of the existence of a significant relationship. Despite this, from which studies are availablet is divided. OBJECTIVE. Describe the influence of hypothyroidism on the type of psychiatric diagnosis and clinical characteristics hospitalized patients at the Technical Unit for Mental Health. MATERIALS AND METHODS. Descriptive and retrospective study with a population of 678 patients and, sample of 472, the inclusion criteria were: older than 18 years: mi-ddle-aged adults aged 18 to 64 and adults over 65 years old, with definitive diagnosis of dischargeaccording to the Classification International Diseases - 10 of mental and behavioral disorders; sample subcategorized in disorders: 259 affective, 131 psychotic, 44 for substance use and 38 anxious; and, in which hypothyroidism was investigated, they were hospitalized and attended for in the Technical Mental Health Unit of the Carlos Andrade Marín Specialities Hospital, during the years 2014 and 2015. The data were analyzed using the Statistical Program International Bu-siness Machines Statistical Package for the Social Sciences, Version 22.0. RESULTS. 51,50% (243; 472) were male; 90% (425; 472) were middle-aged adults; 54,9% (259; 472) were affecti-ve disorders; 18,4% (87; 472) were hypothyroid patients with definitive discharage diagnosis of mental and behavioral disorders that corresponded to the elderly 65 years. Affective disorders 19,7% (51; 259), psychotic 16,8% (22; 131), substance use 13,6% (6; 44) and anxious 21,1% (8; 38). CONCLUSION. There was a significant relationship was shown between hypothyroidism and mental and behavioral disorders especially of the affective type in older adults.

Caracterización clínica y terapéutica del episodio depresivo en pacientes hospitalizados / Clinical and therapeutic characterization of depressive episodes in hospitalized patients

RESUMEN Introducción: la depresión es la enfermedad psiquiátrica más frecuente y puede sufrirse a cualquier edad. Cerca del 20 % de las personas padecen durante su vida una depresión, de ellos el 70 % son mujeres. Objetivo: caracterizar los pacientes hospitalizados con diagnóstico de episodio depresivo según síntomas clínicos, terapia utilizada y presencia de complicaciones, en el Hospital Clínico Quirúrgico Docente Dr. León Cuervo Rubio de Pinar del Río durante los años 2017-2018. Métodos: se realizó un estudio observacional, descriptivo y transversal. El universo quedó constituido por 116 pacientes con el diagnóstico clínico de episodio depresivo que necesitaron tratamiento psicológico durante la hospitalización. Los datos fueron obtenidos de las historias clínicas, mediante la entrevista y la observación. Resultados: se evidenció que el sexo femenino fue el mayor afectado, en edades entre 40-59 años. Como factores de riesgo sociales se incluyeron estados familiares de salud; económicos relacionados con la personalidad del paciente, y los factores biológicos. La disminución de la atención y concentración, perdida de la confianza en sí mismo, sentimientos de inferioridad, ideas de culpa e inutilidad, fueron los principales síntomas. Conclusiones: la disminución de la atención y concentración, estuvieron presentes en todos los pacientes con predominio de ideas de culpa y de inutilidad, las complicaciones escasas fueron escasas, siendo la terapia cognitivo conductual el tratamiento de elección utilizado.

ABSTRACT Introduction: depression is the most common psychiatric illness. About 20% of people suffer from depression during their lifetime, of which 70 % are women and can be suffered at any age. Objective: to characterize hospitalized patients with diagnosis of depressive episode based on clinical symptoms, therapy applied and presence of complications at Dr. León Cuervo Rubio Teaching Clinical Surgical Hospital. Pinar del Río during the years 2017-2018. Methods: an observational, descriptive and cross-sectional study was performed. The target group included 116 patients with clinical diagnosis of depressive episode who needed psychological treatment during hospitalization. Data were obtained from clinical histories, and through interview and observation. Results: it was evidenced that female gender was mostly affected, in ages between 40-59 years. The main risk factors identified were social factors, such as health relatives, economic factors related to the patient's personality, and biological factors. The main symptoms were reduced attention and concentration, loss of self-confidence and feelings of inferiority, guilt and uselessness. Conclusions: decreased of attention and concentration were present in all patients with predominance of guiltiness and uselessness ideas, scarce complications, cognitive behavioral therapy was the treatment of choice.

[The use of strength and difficulties questionnaire in psychosocial evaluation and attention deficit hyperactivity disorder screening in preterm infants]. / Uso del Strength and Difficulties Questionnaire en prematuros para su evaluación psicosocial y cribado del trastorno por déficit de atención e hiperactividad.

INTRODUCTION: Behavioural disorders and learning disabilities are often recognised in<1,500g or<32 weeks very low birth weight (VLBW) infants. There is very limited data in the Spanish population. OBJECTIVE: To determine the presence of psychosocial disorders in preterm infants at 6 years of age, as assessed by the strength and difficulties (SDQ) questionnaire, in comparison to a reference population. To set a cut-off value to use SDQ as a screening tool for attention deficit hyperactivity disorder (ADHD) in the preterm child. PARTICIPANTS AND METHODS: A prospective observational study was conducted on premature children assessed at 6 years of age using the SDQ. Perinatal variables, neurodevelopment, and diagnosis of ADHD, according to the DSM-5, were collected. RESULTS: A total of 214 children who met all the requirements, were included. When compared with the reference population they had significantly higher scores in emotional symptoms, in peer relationships, and in the total score of the test. The hyperactivity scale and the total test score are good predictors of a diagnosis of ADHD, with an area under the ROC curve of 0.83 (95% CI: 0.76-0.90) for hyperactivity, and 0.87 (95% CI: 0.80-0.93) for the total score. The scores for hyperactivity and the total test, from which the screening for ADHD could be considered positive would be≥6 and≥13 respectively, and a combination of hyperactivity≥5 and total score≥12. CONCLUSIONS: Preterm children are at higher risk of emotional and peer relationship problems than those born full term. The SDQ test could be used for ADHD screening.