Asociación entre síntomas de ansiedad y abuso de medicamentos en pacientes adultos ambulatorios con migraña crónica, Trujillo - Perú

OBJETIVO: Determinar la asociación del abuso de medicamentos y síntomas de ansiedad en pacientes adultos ambulatorios con migraña crónica en la Clínica SANNA /Sánchez Ferrer, Trujillo-Perú. MATERIAL Y MÉTODO: Estudio de corte transversal analítico, con una muestra de 104 pacientes con y sin abuso de medicamentos. Se reportan frecuencias absolutas, relativas, promedio y DE según el tipo de variable. En el análisis bivariado por medio del Chi de Homogeneidad y nivel del análisis multivariado, utilizando regresión de Modelos Lineales Generalizados, familia Poisson y función de enlace log, considerando el estimador de varianza robusta [vce(robust)] se determinó la asociación entre el abuso de medicamentos y síntomas de ansiedad. RESULTADOS: Se encontró 96 (92.3%) pacientes de sexo femenino, con una edad media y DE 37.1 ± 9.6. Los síntomas de ansiedad estuvieron presentes en 28 (48.3%) pacientes que abusan de medicamentos y 9 (19.6%) que no abusan de medicamentos (p=0.002). En el análisis multivariado ajustado, los que abusan de medicamentos tienían 2.28 veces mayor riego de prevalencia de padecer síntomas de ansiedad, que aquellos que no abusan de medicamentos (RP= 2.28; IC 95%: 1.17 - 4.47; p= 0.016). CONCLUSIONES: Los pacientes ambulatorios con migraña crónica que abusan de medicamentos tienen mayor riego de prevalencia de padecer sintomas de ansiedad, que aquellos que no abusan de medicamentosOBJECTIVE: To determine the association of medication abuse and anxiety symptoms in ambulatory adult patients with chronic migraine at the SANNA / Sánchez Ferrer Clinic, TrujilloPeru. MATERIAL AND METHOD: Analytical cross-sectional study, with a sample of 104 patients with and without medication abuse. Absolute, relative, average and SD frequencies are reporte according to the type of variable. In the bivariate analysis by means of the Chi square test of Homogeneity and in the multivariate analysis, using regression of Generalized Linear Models, Poisson family and log link function, considering the robust variance estimator [vce (robust)] the association was determined between medication abuse and anxiety symptoms. RESULTS: 96 (92.3%) female patients were found, with a mean age and SD of 37.1 ± 9.6. The symptoms of anxiety were present in 28 (48.3%) patients with medication abuse and 9 (19.6%) without medication abuse (p=0.002). In the adjusted multivariate analysis, it was found that those with medication abuse have a 2.28 times higher risk of having symptoms of anxiety than those without medication abuse (PR = 2.28, 95% CI: 1.17 - 4.47, p = 0.016). CONCLUSIONS: Outpatients with chronic migraine with medication abuse have a greater risk of having symptoms of anxiety than those without medication abuse.Tesi

Riesgos psicológicos en adolescentes en situación de pobreza de un pueblo de la selva peruana

The objective of this work is to determine the relationships of the psychological risk variables: life satisfaction, self-esteem, achievement motivation and future expectations of adolescents from a Peruvian jungle town who live in poverty. The methodology is based on a cross-sectional study, where relative and absolute frequencies were deduced, in the same way measures of central tendency and dispersion, thus the relationships of the variables were also analyzed through Pearson's Chi square with a reliability of 95%. The adolescents involved in the study had a mean age of 14 years, the majority 69 (53.5%) were male and 37 (28.7%) without schooling. Also, 102 (79.1%) reported low life satisfaction, 68 (52.7%) low self-esteem, 90 (69.8%) low achievement motivation, and 86 (66.7) low future expectations. A significant relationship was found between the variables sex (p = .011) and life satisfaction (p = .054) with future expectations. Likewise, future expectations were related to life satisfaction (p = .054) and self-esteem was related to achievement motivation (p = .004). In conclusion, All the psychological risk variables report a high prevalence of the low level, sex and not having schooling have a significant influence, reinforced by the condition of poverty in which they live. It is necessary to promote the psychological health care of this population through the implementation of the community mental health service in the Peruvian jungle.El objetivo del presente trabajo es determinar las relaciones de las variables de riesgos psicológicos: satisfacción vital, autoestima, motivación de logro y expectativas de futuro de los adolescentes de un pueblo de la selva peruana que viven en pobreza. La metodología se basa en un estudio transversal, donde se dedujeron frecuencias relativas y absolutas, del mismo modo medidas de tendencia central y de dispersión, así también se analizó las relaciones de las variables a través del Chi cuadrado de Pearson con una confiabilidad del 95%. Los adolescentes involucrados en el estudio tuvieron una edad media de 14 años, la mayoría 69 (53.5%) fueron de sexo masculino y 37 (28.7%) sin  escolaridad. Así también, 102 (79.1%) reportaron una satisfacción vital baja, 68 (52.7%) autoestima baja, 90 (69.8%) motivación de logro bajo y 86 (66.7) expectativas del futuro bajo. Se encontró relación significativa entre las variables sexo (p=,011) y satisfacción vital (p=,054) con expectativas del futuro. Así también, expectativas del futuro se relacionó con la satisfacción vital (p=,054) y la autoestima se relacionó con la motivación de logro (p=,004). Todas las variables de riesgos psicológicos reportan alta prevalencia del nivel bajo, el sexo y no tener escolaridad influyen 1de forma significativa, reforzado con la condición de pobreza en el que viven. Se requiere promover la atención de la salud psicológica de esta población a través de implementación del servicio de salud mental comunitaria en la selva peruana

Narrative Review on the Therapeutic Approach to Violence against Women during the COVID-19 Pandemic in Latin America

Violence against women during the pandemic has become a problem that has affected the world and to date has caused the death of many women. Although mental health has shown a growing interest in research, it is still very susceptible to being affected. This research described the scientific literature on the challenges in the psychotherapeutic approach in victims of violence against women during the COVID-19 pandemic in Latin America. A narrative review was carried out with a search of documents in the Scopus, Web of Science and PubMed databases, using descriptors for women, violence against women, COVID-19 and Latin America. As a result, 12 studies were included, which reported that the use of helplines, digital platforms of care and teletherapy were advantageous in several Latin American countries during the pandemic; difficulties were found in the accessibility of care for cases, collapse of telephone lines, technical problems of the system and the need for training for health professionals and service providers. It can be concluded that the coping strategies most used during the pandemic were the help services, through telephone and virtual care; there was difficulty in following up and monitoring the case in the medium and long terms, so further studies could focus on it. The main limitation of this work is methodological, since a number of studies could have been excluded from the searches for not including some of the terms in the search equation

Latin American Production on Gender Violence on Scopus, 2010 -2019

The study describes the characteristics of publications on gender violence written by authors affiliated with Latin American institutions, in journals indexed to Scopus during the period 2010-2019. A descriptive and retrospective analysis of 2,568 articles is carried out. Latin American scientific production represents 5.3% of world production. Brazil is the country with the highest production, followed by Mexico and Chile. Latin American scientific production has been published in 572 journals. Ciencia e Saude Coletiva (Brazil) is the journal with the largest number of publications, followed by Cadernos de Saude Publica (Brazil) and Journal of Interpersonal Violence (United States). besides, the authors are mainly affiliated with the Universidade de Sao Paulo - USP, followed by the Fundacao Oswaldo Cruz Universidade Federal do Rio Grande do Sul. Finally, the keywords, domestic violence, intimate partner violence and gender violence present an increasing trend of studies since 2016. Therefore, it is necessary to strengthen and stimulate the generation and dissemination of scientific studies by Latin American researchers

Adaptación y validación de la Patient Health Questionnaire for Depression and Anxiety (PHQ-4) en una muestra de quechua hablantes peruanos

Introduction: The Patient Health Questionnaire for Depression and Anxiety (PHQ-4) is an ultra-brief self-report measure of depression and anxiety symptoms. The PHQ-4 has not been adapted or validated in the Quechua-speaking population. Objective: This study aimed to adapt and validate the PHQ-4 in a sample of the Peruvian Quechua-speaking population with its Collao variant from Puno-Peru. Methods: A total of 221 Quechua speakers of the Collao variant (mean age 31.2 years, SD = 11.7, 47.1% male and 52.9% female) participated. Evidence of validity based on internal structure was evaluated using confirmatory factor analysis (CFA), reliability using the internal consistency method, and item difficulty and discrimination characteristics based on Item Response Theory (IRT). Results: The results indicated that all items of the PHQ-4 were relevant, consistent, and clear enough to adequately represent anxiety and depressive symptoms. The CFA results supported a one-factorial model, in which anxiety and depression items form a single latent variable with high reliability. All items of the PHQ-4 had good discrimination parameters, and the difficulty parameters indicated that the items were comparatively difficult. Therefore, a higher presence of the latent trait (anxiety and depression) is needed to answer higher response categories. Discussion: In conclusion, the PHQ-4 presented good psychometric properties as a rapid, reliable, and valid primary screening measure for Quechua speakers in need of in-depth assessment and symptom monitoring for the diagnosis and treatment of anxiety and depression.Introducción: El Patient Health Questionnaire for Depression and Anxiety (PHQ-4) es una medida de autoinforme ultrabreve de síntomas depresivos y ansiosos. El PHQ-4 no ha sido adaptado ni validado en la población quechua hablante. Objetivo: Este estudio tuvo como objetivo adaptar y validar el PHQ-4 en una muestra de población peruana quechua hablante en su variante Collao de Puno-Perú. Metodología: Participaron 221 personas hablantes de quechua variante collao (promedio de edad de 31,2 años, SD = 11,7, 47,1 % hombres y 52,9 % mujeres). Se evaluó la evidencia de validez basada en la estructura interna, mediante el análisis factorial confirmatorio (CFA), la fiabilidad con el método de consistencia interna y las características de dificultad y discriminación de los ítems en base a la Teoría de Respuesta al Ítem (IRT).  Resultados: Los resultados indicaron que todos los ítems del PHQ-4 son relevantes, coherentes y claros para representar adecuadamente los síntomas de ansiedad y depresión. El resultado del AFC apoyó un modelo unifactorial, donde los ítems de ansiedad y depresión conforman una sola variable latente con una fiabilidad alta. Todos los ítems del PHQ-4 presentas buenos parámetros de discriminación y los parámetros de dificultad indican que los ítems son comparativamente difíciles. Por lo tanto, se necesita una mayor presencia del rasgo latente (ansiedad y depresión) para responder las categorías de respuesta más altas.Discusión: En conclusión, la PHQ-4 presentó buenas propiedades psicométricas como una medida de detección primaria rápida, confiable y válida para personas quechuahablantes que necesitan una evaluación profunda, monitoreo de los síntomas para diagnóstico y tratamiento para la ansiedad o depresión

Translation and validation of the WHO-5 General well-being index into native language Quechua of the Peruvian South

To translate and validate the WHO-5 General Well-being Index for the people of the Peruvian South, a cross-sectional instrumental study was carried out with the voluntary participation of 186 people of both sexes between the ages of 18 and 65 years (M = 29.67 years old; SD = 10.94) living in the south region of Peru. The validity evidence was assessed based on the content using Aiken's coefficient V according to the internal structure through a confirmatory factor analysis, and reliability was calculated through Cronbach's alpha coefficient. The expert judgment was favorable for all items (V > 0.70). The unidimensional structure of the scale was confirmed (χ2 = 10.86, df = 5, p = 0.05; RMR = 0.020; GFI = 0.980; CFI = 0.990; TLI = 0.980 y RMSEA = 0.080), and it presents a suitable reliability range (α = > 0.75). This shows that the WHO-5 General Well-being Index for the people of the Peruvian South is a valid and reliable scale

Cultural adaptation to Bolivian Quechua and psychometric analysis of the Patient Health Questionnaire PHQ-9

Objective: Cultural adaptation of the Patient Health Questionnaire-PHQ-9 to Bolivian Quechua and analysis of the internal structure validity, reliability, and measurement invariance by sociodemographic variables. Methods: The PHQ-9 was translated and back-translated (English-Quechua-English) to optimise translation. For the cultural adaptation, experts, and people from the target population (e.g., in focus groups) verified the suitability of the translated PHQ-9. For the psychometric analysis, we performed a Confirmatory Factor Analysis (CFA) to evaluate internal validity, calculated α and ω indices to assess reliability, and performed a Multiple Indicator, Multiple Cause (MIMIC) model for evaluating measurement invariance by sex, age, marital status, educational level and residence. We used standard goodness-of-fit indices to interpret both CFA results. Results: The experts and focus groups improved the translated PHQ-9, making it clear and culturally equivalent. For the psychometric analysis, we included data from 397 participants, from which 73.3% were female, 33.0% were 18–30 years old, 56.7% reported primary school studies, 63.2% were single, and 62.0% resided in urban areas. In the CFA, the single-factor model showed adequate fit (Comparative Fit Index = 0.983; Tucker-Lewis Index = 0.977; Standardized Root Mean Squared Residual = 0.046; Root Mean Squared Error of Approximation = 0.069), while the reliability was optimal (α = 0.869—0.877; ω = 0.874—0.885). The invariance was confirmed across all sociodemographic variables (Change in Comparative Fit Index (delta) or Root Mean Square Error of Approximation (delta) < 0.01). Conclusions: The PHQ-9 adapted to Bolivian Quechua offers a valid, reliable and invariant unidimensional measurement across groups by sex, age, marital status, educational level and residence.National Institute for Health and Care Researc

Adaptación cultural al Quechua y análisis psicométrico del Patient Health Questionnaire PHQ-9 en población peruana

Objective. To translate and culturally adapt the Patient Health Questionnaire (PHQ-9) to three varieties of Quechua and analyse their validity, reliability, and measurement invariance. Materials and methods. 1) Cultural adaptation phase: the PHQ-9 was translated from English into three variants of Quechua (Central, Chanca, Cuzco-Collao) and translated again into English. Then, experts and focus groups allowed the translations to be culturally adapted. 2) Psychometric phase: the unidimensionality of the adapted PHQ-9 was evaluated by using Confirmatory Factor Analysis (CFA), reliability was evaluated by internal consistency (Alpha and Omega), and measurement invariance according to Quechua varieties and sociodemographic variables was evaluated by using CFA, multigroups and MIMIC models (Multiple Indicator Multiple Cause). Results. Each of the adaptations of the PHQ-9 to the three Quechua varieties reported clear and culturally equivalent items. Subsequently, data from 970 Quechua- speaking adult men and women were analyzed. The general one-dimensional model reported an adequate fit (Comparative fit index = 0.990, Tucker-Lewis index = 0.987, Standardized root mean squared residual= 0.048, Root mean squared error of approximation= 0.071); each of the Quechua varieties also showed an adequate fit. Reliability was high for all varieties (α = 0.865 - 0.915; ω = 0.833 - 0.881). The results of the multigroup CFA and MIMIC models confirmed measurement invariance according to Quechua variant, sex, residence, age, marital status and educational level. Conclusions. The PHQ-9 adaptations to Central Quechua, Chanca and Cuzco-Collao offer a valid, reliable and invariant measurement, confirming that comparisons can be made between the evaluated groups. Its use will benefit mental health research and care for Quechua-speaking populations

Conducta infiel y adicción a redes sociales en adultos de la selva peruana

Addiction to social networks increases the chances of partner infidelity. This research aimed to determine the relationship between unfaithful behavior and addiction to social networks in adults from the commercial areas of Tarapoto, Lamas, San José de Sisa, Moyobamba, and Naranjos, in the Peruvian Amazon region, during the first four-month period of 2021. Thus, a study with a non-experimental design and correlational research type was developed in a sample of 318 individuals between 20 and 40 years old. The Multidimensional Infidelity Inventory and the Social Networks Addiction Questionnaire were applied. 62.3% of the participants were male, 57.5% were between 30 and 59 years old, 66.7% lived with their partners without marriage, and 51.6% were in the second stage of the couple relationship. There were significant differences between men and women regarding unfaithful behavior (U=6387,500; p&lt;0.000). In this context, a predominance of the medium level of addiction to social networks in the participants and the low level in the dimensions of infidelity behavior were observed, establishing a statistically significant correlation between both variables.La adicción a las redes sociales potencia las probabilidades de infidelidad de pareja. Esta investigación tuvo el objetivo de determinar la relación entre conducta infiel y adicción a redes sociales en adultos de las áreas comerciales de Tarapoto, Lamas, San José de Sisa, Moyobamba y Naranjos, región de la Amazonía Peruana, durante el primer cuatrimestre de 2021. Así, se desarrolló un estudio con diseño no experimental y tipo de investigación correlacional, en una muestra de 318 individuos con edades entre 20 y 40 años, a los que se aplicó el Inventario Multidimensional de Infidelidad y el Cuestionario de Adicción a Redes Sociales. El 62,3% de los participantes perteneció al sexo masculino, el 57,5% tenía edades entre 30 y 59 años, el 66,7% convivía con sus parejas sin estar casados y el 51,6% se encontraban en la segunda etapa de la relación de pareja. Existieron diferencias significativas entre hombres y mujeres en cuanto a la conducta infiel (U=6387,500; p&lt;0,000). En este contexto, se observó un predominio del nivel medio de la adición a las redes sociales en los participantes y del bajo en las dimensiones de la conducta de infidelidad, estableciéndose correlación estadísticamente significativa entre ambas variables