Psychiatric symptoms, burnout and associated factors in psychiatry residents

Introduction: Mental health in training physicians is a growing issue. The aim of this study was to investigate emotional distress in psychiatry residents. Method: This web-based survey evaluated 115 (62%) psychiatry residents in training in the Brazilian State of Rio Grande do Sul. The DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Adult, the Patient Health Questionnaire-2, the Alcohol Use Disorders Identification Test-concise, and the Maslach Burnout Inventory were all administered. Linear regression models were estimated with burnout dimensions as dependent variables. Result: Positive screening rates were 53% for anxiety, 35.7% for somatization, 16.5% for depression, and 7% for suicidal ideation. Half of the male residents were at risk of alcohol abuse and dependence. Regarding burnout, 60% met criteria for emotional exhaustion, 54.8% for depersonalization, and 33% for low personal accomplishment. The most consistent risk factors were the nature of the relationships with preceptors, relations to the institutions themselves, age, and the quality of relationships with family. Conclusion: Besides disconcerting rates of psychiatric symptoms, the study revealed that characteristics of the workplace (i.e., the nature of relationships with preceptors and relations to the institution) can be regarded as potential targets for development of interventions aimed at improving mental health during training periods

Comunicación y salud mental: características relacionadas con la empatía en médicas y médicos del primer nivel de atención en Chapecó, Santa Catarina, Brasil

In Brazil, the provision of mental health care in primary care centers has gained strategic importance, as it ensures that users will be able to attend these services within their communities, and empathy is a key aspect in the development of the doctor-patient relationship. The aim of this study was to identify characteristics related to empathy in physicians who work in primary care centers and who provide care to individuals with mental disorders. Qualitative research was carried out in 2016, based on semi-structured interviews with eight general and family physicians. Material from the interviews was analyzed using content analysis techniques and three categories emerged: empathy in the active listening of the physician, strategies that allow for better patient care, and the mobilization of emotions. The use of empathy is intrinsically linked to the resolutive capacity of care, and the characteristics identified were active listening, resource management, and the development of methods to overcome the structural obstacles of daily routines.En Brasil, el cuidado en salud mental en los centros de atención primaria se tornó estratégico, dado que garantiza que el usuario asista en su territorio, y la empatía es de gran importancia en el desarrollo de la relación médico-paciente. El objetivo de este estudio fue identificar características relacionadas con la empatía en médicas y médicos que trabajan en el primer nivel y atienden a personas con sufrimiento mental. Se realizó una investigación cualitativa, en 2016, con entrevistas semiestructuradas a ocho médicas y médicos generalistas y de familia. Los relatos se analizaron con la técnica de análisis de contenido y se identificaron tres categorías: empatía en la escucha activa del médico, estrategias que permitan una mejor atención del paciente y movilización de sentimientos. El uso de la empatía está intrínsecamente relacionado con la resolutividad de la atención y las características encontradas fueron la utilización de la escucha activa, el manejo de recursos y el desarrollo de métodos para superar trabas estructurales del cotidiano

Quem são os estudantes de Medicina que tentam suicídio?

Estudantes de medicina apresentam maior risco de tentativa de suicídio em comparação com a população em geral, com uma prevalência de 6,9%. Não está claro quais são os principais fatores de risco associados a tentativas de suicídio nesta população, ressaltando que o conhecimento de tais informações podem ajudar na identificação e intervenção mais precoce em alunos que estejam em risco. Neste estudo, objetivamos identificar fatores associados a tentativas de suicídio em estudantes de medicina. Nossos dados são provenientes de estudo transversal conduzido em 2017 entre estudantes de Medicina brasileiros em formação. Regressão de Poisson multivariada foi realizada para identificar os fatores associados às tentativas de suicídio. Também usamos um modelo de machine learning chamado elastic net para reconhecer o padrão do aluno que tenta o suicídio. Um total de 4.840 pessoas foram incluídas no presente estudo. Os fatores de risco associados à tentativa de suicídio na regressão de Poisson multivariada foram os seguintes: sexo feminino (RP-1,64; IC 95% 1,29-2,08; P <0,001); ser homossexual (RP-2,93; IC 95% 2,19-3,91; P <0,001); menor renda (PR-1,33; IC 95% 1,04-1,70; P = 0,026); bullying na Universidade (PR-1,32; IC 95% 1,08-1,60; P = 0,006); história de trauma na infância (RP-1,39; IC 95% 1,14-1,72; P = 0,001) ou na idade adulta (RP-1,44; IC 95% 1,16-1,78; P = 0,001); história familiar positiva para suicídio (RP-1,36; IC 95% 1,09-1,69; P = 0,005); ter tido ideação suicida no último mês (RP-2,15; IC 95% 1,76-2,62; P <0,001); uso diário de tabaco (RP-1,51; IC 95% 1,03-2,22; P = 0,037) e estar sob risco severo de abuso de álcool (RP-1,45; IC 95% 1,05-1,99; P = 0,023). A prevalência de tentativa de suicídio em nossa amostra foi de 8,94%. O modelo elastic net teve um bom desempenho e encontrou uma area under the curve (AUC) de 0,83. Este é o primeiro estudo a identificar fatores associados a tentativas de suicídio em estudantes de medicina. Futuros estudos longitudinais devem confirmar a relação causal entre esses fatores e tentativas de suicídio. Além disso, esses resultados demonstram que um algoritmo de risco preciso pode ser criado usando informações facilmente acessíveis. No entanto, a validação do algoritmo é necessária em amostras prospectivas.Medical students are at increased risk for suicide attempt compared to the general population, with a 6.9% prevalence. However, it is unclear what are the major risk factors associated with suicide attempts in this population - such information could help identify and intervene earlier with at risk students. In this study we aimed to identify factors associated with suicide attempts in medical students. Our raw data came from a cross-sectional web-based survey conducted in 2017 among Brazilian undergraduate medical students. Multivariate Poisson regression was performed to identify factors associated to suicide attempts. We also used elastic net regularization to recognize the pattern of the student who attempt suicide. A total of 4,840 people were included in the present study. Risk factors associated with suicide attempt in the multivariate Poisson regression were the following: female gender (PR-1.64; CI 95% 1.29-2.08; P<0.001); being homosexual (PR-2.93; CI 95% 2.19-3.91; P<0.001); lower income (PR-1.33; CI 95% 1.04-1.70; P=0.026); bullying in the University (PR-1.32; CI 95% 1.08-1.60; P=0.006); experienced some type of trauma as a child (PR-1.39; CI 95% 1.14-1.72; P=0.001) or adult (PR-1.44; CI 95% 1.16-1.78; P=0.001); family history positive for suicide (PR-1.36; CI 95% 1.09-1.69; P=0.005); endorsed suicidal ideation in the last month (PR-2.15; CI 95% 1.76-2.62; P<0.001); reporting daily tobacco use (PR-1.51; CI 95% 1.03-2.22; P=0.037) and being at severe risk for alcohol abuse (PR-1.45; CI 95% 1.05-1.99; P=0.023). Prevalence of suicidal attempt in our sample was 8.94%. Our elastic net model has a good performance and found an area under the curve (AUC) of 0.83. This is the first study to identify factors associated with suicide attempts among Brazilian medical students. Future longitudinal studies should confirm the causal relationship between these factors and suicide attempt. Additionally, these results demonstrate that an accurate risk algorithm can be created using easily accessible information. However, validation of the algorithm is needed in prospective samples

Comunicación y salud mental: características relacionadas con la empatía en médicas y médicos del primer nivel de atención en Chapecó, Santa Catarina, Brasil

In Brazil, the provision of mental health care in primary care centers has gained strategic importance, as it ensures that users will be able to attend these services within their communities, and empathy is a key aspect in the development of the doctor-patient relationship. The aim of this study was to identify characteristics related to empathy in physicians who work in primary care centers and who provide care to individuals with mental disorders. Qualitative research was carried out in 2016, based on semi-structured interviews with eight general and family physicians. Material from the interviews was analyzed using content analysis techniques and three categories emerged: empathy in the active listening of the physician, strategies that allow for better patient care, and the mobilization of emotions. The use of empathy is intrinsically linked to the resolutive capacity of care, and the characteristics identified were active listening, resource management, and the development of methods to overcome the structural obstacles of daily routines.En Brasil, el cuidado en salud mental en los centros de atención primaria se tornó estratégico, dado que garantiza que el usuario asista en su territorio, y la empatía es de gran importancia en el desarrollo de la relación médico-paciente. El objetivo de este estudio fue identificar características relacionadas con la empatía en médicas y médicos que trabajan en el primer nivel y atienden a personas con sufrimiento mental. Se realizó una investigación cualitativa, en 2016, con entrevistas semiestructuradas a ocho médicas y médicos generalistas y de familia. Los relatos se analizaron con la técnica de análisis de contenido y se identificaron tres categorías: empatía en la escucha activa del médico, estrategias que permitan una mejor atención del paciente y movilización de sentimientos. El uso de la empatía está intrínsecamente relacionado con la resolutividad de la atención y las características encontradas fueron la utilización de la escucha activa, el manejo de recursos y el desarrollo de métodos para superar trabas estructurales del cotidiano