Suicidal behaviour and associated factorsin Colombia. Results from the 2015 national mental health survey

Introducción La conducta suicida es un desenlace importante como causa de mortalidad en el mundo, por lo que es relevante conocer los factores asociados a la conducta para la intervención clínica y el diseño de políticas de salud pública que permitan disminuir su incidencia. Objetivo Describir los resultados de la Encuesta Nacional de Salud Mental 2015 relacionados con la conducta suicida en adultos. Resultados Se observa que el 5,5% (intervalo de confianza del 95%, 4,5%-6,7%) de los varones y el 7,6% (intervalo de confianza del 95%, 6,6%-8,7%) de las mujeres han pensado en suicidarse. Reportan plan de suicidio el 2,7% (intervalo de confianza del 95%, 2,1%-3,0%) de las mujeres y se observa intento de suicidio en el 1,9% (intervalo de confianza del 95%, 1,4%-2,5%) de los varones y el 3,3% (intervalo de confianza del 95%, 2,6%-4,1%) de las mujeres. La región con la más alta frecuencia de ideación suicida fue Bogotá (el 10,3%; intervalo de confianza del 95%, 7,6%-13,8%) y la más baja, en la región Atlántica (el 3,8%; intervalo de confianza del 95%, 3,0%-4,8%). Se ha encontrado que la presencia de cualquier trastorno mental, en particular los trastornos depresivos y de ansiedad y los rasgos limítrofes de personalidad, se asocian a ideación suicida grave, así como haber sufrido desplazamiento por violencia alguna vez en la vida. No se ha encontrado diferencia en la ideación suicida relacionada con la pobreza o problemas derivados del consumo de alcohol. Conclusiones La conducta suicida es frecuente en la población de adultos colombianos, lo que amerita el diseño y la aplicación de intervenciones en los grupos más vulnerables con el fin de disminuir este riesgo.Q468-75Introduction Suicidal behaviour leads to a significant cause of mortality in the world. It is important to know the factors associated with this behaviour in order to design public health policies that may decrease its incidence. Objective Describe the results of the Colombian National Survey of Mental Health related to suicidal behaviour in adults. Results It was observed that 5.5% (95% CI, 4.5-6.7) of men and 7.6% (95% CI, 6.6-8.7) of women had suicidal thoughts. A suicide plan was reported in 2.7% of women (95% CI, 2.1-3.0), and attempted suicide observed in 1.9% of men (95% CI, 1.4-2.5) and 3.3% of women (95% CI, 2.6-4.1). The region with the highest frequency of suicidal ideation was Bogotá, with 10.3% (95% CI, 7.6-13.8) and was the lowest in the Atlantic region with 3.8% (95% CI, 3.0-4.8). It was found that the presence of any mental illness, especially depressive, anxiety disorders and borderline personality traits, as well as people who have been displaced by violence at least once in life, are associated with serious suicidal ideation. No differences were found in suicidal ideation as regards poverty or problems arising from alcohol consumption. Conclusions Suicidal behaviour is common in the Colombian adult population, which warrants the design and implementation of interventions in the most vulnerable groups in order to reduce this risk

Poverty and Mental Disorders in the Colombian Population: National Mental Health Survey 2015

Introducción: La pobreza se ha relacionado en algunos estudios con peores desenlaces en problemas y trastornos mentales. Se lo considera un círculo en el cual la pobreza favorece la aparición de la enfermedad mental y esta a su vez conduce a mayor pobreza. En Colombia no existen estudios al respecto. Objetivo: Describir la asociación en Colombia entre problemas y trastornos mentales y la condición de pobreza según el Índice de Pobreza Multidimensional (IPM). Material y métodos: Empleando la muestra de la Encuesta Nacional de Salud Mental 2015, ponderada por los factores de expansión para la población, mediante entrevistas semiestructuradas se emplearon los instrumentos SRQ-20, AUDIT C y A, PCL-modificado, APGAR familiar y CIDI-CAPI, para establecer la prevalencia de problemas y trastornos mentales, clasificando entre pobres y no pobres según el IPM. Resultados: Se entrevistó en total a 13.200 hogares, el 13,5% de ellos en condición de pobreza; en estos, el 6,2% de la población adolescente reportó algún trastorno a lo largo de la vida y el 4,6% en los últimos 12 meses; en contraste, en el mismo grupo de edad, pero no en condición de pobreza, las tasas fueron del 7,2 y el 3,3% respectivamente. En adultos en pobreza, la prevalencia de trastornos a lo largo de la vida fue del 9,2 y el 4,3% en el último año; los no pobres mostraron prevalencias del 9,1 y el 3,9 respectivamente. Conclusiones: Existe una relación entre no acceder de manera suficiente a la canasta de bienes básica y la presencia de afecciones mentales en la población colombiana; no obstante, no parece que haya asociación entre la exacerbación de la pobreza y un mayor deterioro de la salud mental.Q431-38Introduction: Poverty has been associated in some studies with poorer outcomes in mental problems and disorders.Acircular relationship has been considered in which poverty fosters the appearance of mental illness and this facilitates greater poverty. There are no studies in Colombia on this subject. Objective: To describe the association between mental problems and disorders and poverty according to the Multidimensional Poverty Index (MPI) in Colombia. Material and methods: Using the 2015 National Mental Health Survey, adjusted with the expansion factors for the population. The prevalences of mental problems and disorders obtained through semi-structured interviews employing the instruments SRQ-20, AUDIT C and A, modified PCL, familiar APGAR and CIDI CAPI. The poverty status was determined by the MPI. Results: A total of 13,200 households were interviewed, of which 13.5% were classified as in a poverty condition, 6.3% of the adolescents of poor households reported a life-time prevalence of any mental disorder, and 4.6% in the last 12 months. On the other hand, the prevalences for the same age group not in a poverty condition were 7.2% and 3.3%, respectively. For adults in poverty, the prevalence of life-time mental disorders were 9.2%, with 4.3% in the last year, while those not considered poor showed prevalences of 9.1% and 3.9% for the same time periods. Conclusions: For the population of Colombia, there is a relationship between not being able to access the basic basket of goods and the presence of mental diseases, although there does not seems to be an association between an increase in poverty and the deterioration of mental health

Prevalence of irritable bowel syndrome and health-related quality of life in adults aged 18 to 30 years in a Colombian University: an electronic survey

Q2Artículo original1-9Comunindad de la Pontificia Universidad JaverianaBackground We estimated the prevalence of irritable bowel syndrome (IBS) and its impact on patient-reported health-related quality of life (HR-QOL) in a university-based population aged between 18 and 30 years in Bogotá, Colombia. Methods The study had a cross-sectional design. Students, faculty, and staff aged 18-30 years of the Pontificia Universidad Javeriana, Bogotá, Colombia were randomly selected and invited to complete an electronic survey containing the Rome III IBS diagnostic cuestionnaire and an IBS-specific HR-QOL instrument (IBS-QOL). Results A total of 1082 individuals participated in this study. The prevalence of IBS was 24.0% (95% CI 21.3-26.6%). IBS-constipation was the most common subtype (41.9%; 95% CI 35.5-48.4%). The overall IBS-QOL score indicated HR-QOL impairment (72.1/100). IBS-unsubtyped patients had the highest overall HR-QOL (constipation: 70.6; diarrhea: 67.2; mixed: 67.0; unsubtyped: 77.8; P=0.003). IBS non-consulters had higher IBS-QOL “Food Avoidance” scores than IBS consulters (60.3 vs. 45.5; P=0.002). Conclusion IBS is a prevalent disorder in a university-based population aged 18-30 years and has a significant impact on HR-QOL. IBS-unsubtyped subjects had the highest HR-QOL compared to other subtypes. Food avoidance appears to be a key factor in seeking consultation

Perfil epidemiológico de la infección por SARS-COV-2 en pediatría

Objetivo: Describir el perfil epidemiológico y clínico de los pacientes pediátricos que fueron atendidos por sospecha de infección de COVID-19, entre marzo y octubre del 2020, en el Hospital Universitario San Ignacio (HUSI), en Bogotá, Colombia. Materiales y métodos:Diseño de corte transversal. Descripción de los pacientes con edades comprendidas entre 1 mes de vida hasta 1 día antes de cumplir 18 años, valorados entre en marzo y octubre del 2020, que fueron abordados por cualquier servicio de atención pediátrica de un hospital universitario por sospecha de infección por COVID-19, según los protocolos nacionales e institucionales vigentes. Se registraron variables demográficas y el motivo de consulta de todos los individuos con sospecha de infección. Únicamente cuando se confirmó la infección por SARS-CoV-2 se registraron las variables relacionadas con aspectos clínicos de la enfermedad y su evolución. Resultados: Se evaluaron 920 registros médicos de pacientes pediátricos con sospecha de infección por SARS-CoV-2, de los cuales hubo 157 casos confirmados con infección por COVID-19. El principal motivo de consulta para sospechar infección fue fiebre en un 50% de los casos. En los pacientes con confirmación virológi-ca el 32.48% de los casos atendidos requirieron manejo hospitalario. Se sospechó MIS-C en 5 pacientes que requirieron manejo en unidad de cuidados intensivos. En el lapso evaluado no hubo fallecimientos asociados a la infección por COVID-19. Conclusiones: La infección por SARS-CoV-2 se relaciona en la mayoría de los casos con un espectro de enfermedad leve en la población pediátrica. Este estudio sugiere que podrían ser mayores los pacientes pediátricos que debutan con síntomas gastrointestinales que respiratorios, y que la frecuencia de complicaciones renales debe ser tenida en cuenta en los pacientes en quienes se sospecha el síndrome inflamatorio sistémico asociado al COVID-19Objective: To describe the epidemiological and clinical profile of pediatric patients who were treated for suspected COVID-19 infection, between March and Octo-ber 2020, at the Hospital Universitario San Ignacio (HUSI), in Bogotá, Colombia. Materials and methods: Cross-sectional design. Description of patients aged 1 month to 1 day before their 18th birthday, assessed between March and October 2020, who were approached by any pediatric care service of a university hospital for suspected COVID-infection. 19, according to current national and institutional protocols. Demographic variables and the reason for consultation of all individuals with suspected infection were recorded. Only when SARS-CoV-2 infection was confirmed were variables related to clinical aspects of the disease and its evolution recorded. Results: 920 medical records of pediatric patients with suspected SARS-CoV-2 infection were evaluated, of which there were 157 confirmed cases with COVID-19 infection. The main reason for consultation to suspect infection was fever in 50% of the cases. In patients with virological confirmation, 32.48% of the cases at-tended required hospital management. MIS-C was suspected in 5 patients who required intensive care unit management. In the evaluated period, there were no deaths associated with COVID-19 infection.Conclusions: SARS-CoV-2 infection is related in most cases to a spectrum of mild disease in the pediatric population. This study may be larger than pediatric patients presenting with gastrointestinal rather than respiratory symptoms, and the frequency of renal complications should be taken into account in patients in whom the systemic inflammatory syndrome associated with COVID-19 is suspected.Revista Nacional - IndexadaS

Validation of the Montgomery-Åsberg Depression Rating Scale (MADRS) in Colombia

Objetivo: Adaptar y validar la Montgomery-Åsberg Depression Rating Scale (MADRS) en el medio colombiano. Metodología: Estudio de tipo observacional para la validación de una escala. Se precisó la validez de criterio determinando los puntos de corte del instrumento a través de los valores desensibilidad y especificidad de la gravedad de la enfermedad, al contrastarla con los criterios de la Clasificación Internacional de Enfermedades (CIE-10). Se realizó un análisis factorial de la escala; se determinó la consistencia interna del instrumento; se evaluó la reproducibilidad interevaluadores a través de la evaluación de 22 pacientes por cuatro investigadores diferentes, y se estableció la sensibilidad al cambio de la escala en 28 sujetos aplicando el instrumento tras un lapso de 14-28 días. Resultados: El estudio se llevó a cabo en la ciudad de Bogotá, donde se aplicó a 150 pacientes con diagnóstico de depresión mayor. El punto de corte para depresión moderada fue 20 (sensibilidad, 98%; especificidad, 96%) y para grave, 34 (sensibilidad, 98%; especificidad,92%). Se evidenció que el instrumento es unidimensional y posee buena consistencia interna( = 0,9168). Los hallazgos de las pruebas de confiabilidad interevaluadores demostraron que el instrumento es altamente confiable (coeficiente de correlación intraclase = 0,9833).El instrumento tiene buena sensibilidad al cambio. Conclusiones: La versión colombiana de la escala de evaluación de la depresión Montgomery-Åsberg tiene buenas propiedades psicométricas y se puede utilizar en la práctica clínica yen investigaciones relacionadas con el trastorno depresivo.Q4Artículo original146-155Pacientes diagnosticados con depresión mayorObjective: To adapt and to validate the Montgomery-Åsberg Depression Rating Scale (MADRS) in Colombia. Methods: Observational study for scale validation. Validity criteria were used to determine the severity cut-off points of the tool. Taking into account sensitivity and specificity values, those cut points were contrasted with ICD-10 criteria for depression severity. A a factor analysis was performed. The internal consistencY was determined with the same sample of patients used for the validity criteria. Inter-rater reliability was assessed by evaluating the 22 records of the patients that consented to a video interview. Sensitivity to change was established through a second application of the scale in 28 subjects after a lapse of 14 to 28 days. Results: The study was performed in Bogotá, the tool was applied in 150 patients suffering from major depressive disorder. The cut-off point for moderate depression was 20 (sensitivity, 98%; specificity, 96%), and the cut-off point for severe depression was 34 (sensitivity, 98%; specificity, 92%). The tool appears as a unidimensional scale, which possesses a good internal consistency with ( =.9168). The findings of inter-rater reliability evaluation showed the scale as highly reliable (intraclass correlation coefficient=.9833). The instrument has a good sensitivity to change. Conclusions: The Colombian version of the Montgomery-Åsberg Depression Rating Scale has good psychometric properties and can be used in clinical practice and in clinical research in the field of depressive disorder

Presenteeism, absenteeism, and lost work productivity among depressive patients from five cities of Colombia

Q215-19Pacientes adultos diagnosticados con depresión mayor o dobleObjectives To estimate productivity losses due to absenteeism and presenteeism and their determinants in patients with depression from five Colombian cities. Methods We used data from a multicenter, mixed-methods study of adult patients diagnosed with major depressive disorder or double depression (major depressive disorder plus dysthymia) during 2010. The World Health Organization’s Health and Work Performance Questionnaire was used to assess absenteeism and presenteeism. We explored the determinants of productivity losses using a two-part model. We also used a costing model to calculate the corresponding monetary losses. Results We analyzed data from 107 patients employed in the last 4 weeks. Absenteeism was reported by 70% of patients; presenteeism was reported by all but one. Half of the patients reported a level of performance at work at least 50% below usual. Average number of hours per month lost to absenteeism and presenteeism was 43 and 51, respectively. The probability of any absenteeism was 17 percentage points lower in patients rating their mental health favorably compared with those rating it poorly (standard error [SE] 0.09; P < 0.10) and 19 percentage points higher in patients with at least one comorbidity compared with patients with none (SE 0.10; P < 0.10). All other covariates showed no significant associations on hours lost to absenteeism. Patients with favorable mental health self-ratings had 16.4 fewer hours per month of presenteeism compared with those with poor self-ratings (SE 4.52; P < 0.01). The 2015 monetary value of productivity losses amounted to US $840 million. Conclusions This study in a middle-income country confirms the high economic burden of depression. Health policies and workplace interventions ensuring adequate diagnosis and treatment of depression are recommended