Prevalencia de problemas de salud mental y su asociación con variables socioeconómicas, de trabajo y salud : resultados de la encuesta nacional de salud de España

El objetivo del estudio es conocer la prevalencia de personas con problemas de salud mental en España y su asociación con variables socioeconómicas, de trabajo y salud. Se trata de un estudio transversal con los datos de la Encuesta Nacional de Salud de España (2006) en el que participaron 29.476 personas (16 y 64 años). El instrumento de cribado de problemas de salud mental utilizado es el General Health Questionnaire (GHQ-12). Se realizaron análisis descriptivos y de regresión logística para verificar la asociación entre la prevalencia de problemas de salud mental y las variables independientes. La prevalencia de problemas de salud mental es mayor en mujeres (24,6%) que en hombres (14,7%). Las variables más asociadas a una mayor prevalencia de problemas de salud mental son estar separado o divorciado, ser inmigrante de un país en vías de desarrollo, tener peores condiciones socioeconómicas, tener poco apoyo social (hombres OR 3,6; mujeres OR 3,3), estar desempleado o en baja laboral, tener enfermedades crónicas, estar limitado/a en la realización de actividades cotidianas en función de un problema de salud (hombres OR 7,5; mujeres OR 7,1). Estos resultados permiten la identificación de grupos de la población más vulnerables y pueden ser de utilidad para diseñar intervencionesThe aim of this study is to determine the prevalence of people with mental health problems in Spain and their association with socioeconomic, health and work variables. This is a cross-sectional study with data from the National Health Survey of Spain including 29,476 non-institutionalized people between 16 and 64 years of age. The screening instrument of mental health problems used is the General Health Questionnaire (GHQ-12). Descriptive analyses were performed, and logistic regression was used to verify the association between the prevalence of mental health problems and independent variables, by calculating odds ratios (OR) and the confidence interval. The prevalence of mental health problems is higher in women (24.6%) than in men (14.7%). The variables associated with an increased prevalence of mental health problems are being separated or divorced, being an immigrant from a developing country (men OR 1.3; women OR 1.5), having little social support (men OR 3.6; women OR 3.3), being unemployed or on sick leave, having chronic diseases, and being restricted or severely restricted in one's daily activities because of a health problem (men OR 7.5; women OR 7.1). These results allow the identification of the most vulnerable population groups and may be useful to design intervention

Propiedades psicométricas y valores normativos del General Health Questionnaire (GHQ-12) en población general española

El objetivo principal del presente estudio es analizar las propiedades psicométricas del General Health Questionnaire (GHQ-12) como un instrumento de cribado en una muestra representativa de la población española, y en población mayor de 65 años. Se trata de un estudio instrumental utilizando los datos de la Encuesta Nacional de Salud de España (2006). Fueron entrevistadas 29.476 personas mayores de 16 años, no institucionalizadas. Se realizaron análisis de correlación entre ítems, análisis de consistencia interna, un análisis factorial exploratorio (AFE) y un análisis de validez externa del GHQ-12. Todos los análisis fueron realizados utilizando dos métodos de puntuación (Likert y GHQ). Los resultados muestran que cada uno de los ítems del GHQ se correlaciona con los demás, presentando valores de correlación superiores a 0,51. El análisis factorial exploratorio confirma que gran parte de la variabilidad del instrumento (67% Likert y 73% GHQ) puede ser explicada al reunir todos los ítems en un único factor. El GHQ-12 presenta una elevada consistencia interna en población general y también en población mayor de 65 años. Los análisis factoriales confirman que el GHQ-12 puede ser utilizado como un instrumento unidimensional de cribado y la puntuación más adecuada en este caso es la puntuación GHQThe main objective of this study is to analyze the psychometric properties of the General Health Questionnaire (GHQ-12) as a screening instrument in a representative sample of the Spanish population, and among people older than 65 years. This is a instrumental study using data from the National Health Survey of Spain (2006). The sample include 29,476 non-institutionalized interviewed persons over 16 years. Correlation analysis was carried out between items, internal consistency analysis, exploratory factor analysis (EFA) and a discussion of external validity of GHQ-12. All analyzes were performed using two scoring methods (Likert and GHQ). The results showed that the GHQ-12 has a high internal consistency in the general population and in people older than 65 years. Each of the items in the GHQ correlated with others, showing correlation values greater than .51. Exploratory factor analysis confirmed that much of the variability of the instrument (67% Likert and 73% GHQ) may be explained by gathering all the items into a single factor. The factor analysis confirmed that the GHQ-12 can be used as a unidimensional screening and scoring most appropriate in this cas

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A novel amplitude binning strategy to handle irregular breathing during 4DMRI acquisition: improved imaging for radiotherapy purposes.

Background For radiotherapy of abdominal cancer, four-dimensional magnetic resonance imaging (4DMRI) is desirable for tumor definition and the assessment of tumor and organ motion. However, irregular breathing gives rise to image artifacts. We developed a outlier rejection strategy resulting in a 4DMRI with reduced image artifacts in the presence of irregular breathing.Methods We obtained 2D T2-weighted single-shot turbo spin echo images, with an interleaved 1D navigator acquisition to obtain the respiratory signal during free breathing imaging in 2 patients and 12 healthy volunteers. Prior to binning, upper and lower inclusion thresholds were chosen such that 95% of the acquired images were included, while minimizing the distance between the thresholds (inclusion range (IR)). We compared our strategy (Min95) with three commonly applied strategies: phase binning with all images included (Phase), amplitude binning with all images included (MaxIE), and amplitude binning with the thresholds set as the mean end-inhale and mean end-exhale diaphragm positions (MeanIE). We compared 4DMRI quality based on: Data included (DI); percentage of images remaining after outlier rejection. Reconstruction completeness (RC); percentage of bin-slice combinations containing at least one image after binning. Intra-bin variation (IBV); interquartile range of the diaphragm position within the bin-slice combination, averaged over three central slices and ten respiratory bins. IR. Image smoothness (S); quantified by fitting a parabola to the diaphragm profile in a sagittal plane of the reconstructed 4DMRI. A two-sided Wilcoxon's signed-rank test was used to test for significance in differences between the Min95 strategy and the Phase, MaxIE, and MeanIE strategies.Results Based on the fourteen subjects, the Min95 binning strategy outperformed the other strategies with a mean RC of 95.5%, mean IBV of 1.6 mm, mean IR of 15.1 mm and a mean S of 0.90. The Phase strategy showed a poor mean IBV of 6.2 mm and the MaxIE strategy showed a poor mean RC of 85.6%, resulting in image artifacts (mean S of 0.76). The MeanIE strategy demonstrated a mean DI of 85.6%.Conclusions Our Min95 reconstruction strategy resulted in a 4DMRI with less artifacts and more precise diaphragm position reconstruction compared to the other strategies.Trial registration Volunteers: protocol W15_373#16.007; patients: protocol NL47713.018.14