STOP-Bang as a predictor of obstructive sleep apnea-hypopnea syndrome in outpatients

The STOP-Bang has been promoted as a valuable tool for identifying obstructive sleep apnea-hypopnea syndrome (OSAHS) in medical and surgical patients. However, its performance in Colombian samples is unknown. The objective of this study was to determine the clinimetric performance of the STOP-Bang index versus the study of polysomnography in patients from Santa Marta, Colombia. An accuracy study of diagnostic tests with a test-based approach was designed. Seven hundred sixty-two adults referred for polysomnography to evaluate OSAHS were included in the research. They were aged between 18 and 94 years old (mean=47.2, SD=13.4), 63.3% were men, and 46.5% were classified as obese. The STOP-Bang performance was compared against the best reference criterion, the hypopnea/apnea index determined by polysomnography. The diagnosis of OSAHS was confirmed in 461 (60.5%) and corroborated in 301 (39.5%). The area under the curve was 0.70 (95%CI 0.66-0.74), and the best cut-off point was 4, with a sensitivity of 79.2%, a specificity of 53.5%, the positive predictive value of 72.2%, the negative predictive value of 62.6%, positive likelihood ratio was 1.70, negative likelihood ratio was 0.39; OR=4.08 (CI95% 2.99-5.56) and Cohen's kappa of 0.33. As conclusions, performance indicators show that STOP-Bang...

Response rate to an online questionnaire amidst the COVID-19 pandemic in undergraduate students and graduates from a Colombian university

In epidemiology and public health research, caution is necessary when addressing results reported by studies based on the administration of online questionnaires. The most critical limitation in such studies is their impossibility of guaranteeing the representativeness of the sample. However, when having a representative sample is secondary, online questionnaires are an excellent alternative for exploratory studies that seek to obtain information about emerging phenomena quickly and cost-effectively or address sensitive issues, for this approach allows reaching populations difficult to get in contact with using traditional strategies. Online research allows the complete anonymity of participants and ensures they provide a more honest response, regardless of their social desirability, any stigma, or discrimination.

Psychometric Properties of the Five-Item Francis Attitude Towards Christianity Scale in Colombian Psychiatric Outpatients

This study aimed to know the psychometric properties of the five-item Francis scale of the attitude towards Christianity (Francis-5) by assessing psychiatric outpatients in Santa Marta, Colombia. A sample of 260 adult patients participated. The exploratory and confirmatory factor analyses revealed an excellent one-dimensional structure with high internal consistency. It was concluded that the Francis-5 exhibited good indicators of validity and reliability in Colombian psychiatric outpatients.

Brief Spanish Zung Self-Rating Anxiety Scale: Dimensionality, Internal Consistency, Nomological Validity, and Differential Item Functioning Among Chronic Obstructive Pulmonary Disease Patients in Colombia

BACKGROUND AND PURPOSES

The brief Spanish Zung Self-Rating Anxiety Scale is a tenitem tool available; however, there is little information about its psychometric performance. The study aimed to test the dimensionality, internal consistency, nomological validity, and gender differential item functioning of the scale in patients with chronic obstructive pulmonary disease (COPD) in Colombia.

METHODS

A psychometric study was designed. It participated in 408 COPD patients aged between 40 and 102 years.

RESULTS

The confirmatory factor analysis showed both one- and two-dimension structures with acceptable goodness-of-fit indicators. The brief Spanish Zung Self-Rating Anxiety Scale presented high internal consistency, acceptable nomological validity, and non-gender differential functioning.

CONCLUSIONS

The brief Spanish Zung Self-Rating Anxiety Scale presents some good indicators of validity and reliability, and it can be used in the measurement of anxiety in COPD patients.

Stigmatisation associated with COVID-19 in the general Colombian population

BACKGROUND

As the COVID-19 pandemic progresses, the fear of infection increases and, with it, the stigma-discrimination, which makes it an additional problem of the epidemic. However, studies about stigma associated with coronavirus are scarce worldwide.

AIMS

To determine the association between stigmatisation and fear of COVID-19 in the general population of Colombia.

METHOD

A cross-sectional study was carried out. A total of 1,687 adults between 18 and 76 years old (M = 36.3; SD = 12.5), 41.1% health workers, filled out an online questionnaire on Stigma-Discrimination and the COVID-5 Fear Scale, adapted by the research team.

RESULTS

The proportion of high fear of COVID-19 was 34.1%; When comparing the affirmative answers to the questionnaire on stigma-discrimination towards COVID-19, it was found that the difference was significantly higher in the general population compared to health workers in most of the questions evaluated, which indicates a high level of stigmatisation in that group. An association between high fear of COVID-19 and stigma was evidenced in 63.6% of the questions in the questionnaire.

CONCLUSION

Stigma-discrimination towards COVID-19 is frequent in the Colombian population and is associated with high levels of fear towards said disease, mainly people who are not health workers.

Discrimination starts with adjectives

Discrimination starts with adjectives.

Healthcare workers' distress and perceived discrimination related to COVID-19 in Colombia

This study examined the association of perceived discrimination related to COVID‐19 with psychological distress in healthcare workers in the Colombian Caribbean region. The authors designed and conducted a cross‐sectional study, recruiting a non‐probabilistic sample by email or instant messaging. Participants filled out a questionnaire including scales for perceived discrimination, anxiety, depression, perceived stress related to COVID‐19, and suicide risk. Healthcare workers (n = 150) aged 18 to 68 years participated; of these, 72% were women, and the breakdown by occupation was 39.3% nursing assistants, 18.0% nurses, and 42.7% physicians. Perceived discrimination scores showed positive correlations with depressive symptoms among nursing assistants and physicians (r_s = 0.34), and suicide risk in nursing assistants (r_s = 0.35) and physicians (r_s = 0.31). Among nurses, all measurements were independent of perceived discrimination. Nursing assistants scored highest in perceived discrimination. Physicians scored higher for COVID‐19 perceived stress than nursing assistants, and nurses showed similar scores to physicians. In conclusion, perceived discrimination is related to depressive symptoms and suicide risk among nursing assistants and physicians. Nursing assistants report more perceived discrimination than nurses and physicians.

Confirmatory Factor Analysis, Internal Consistency, Gender Differential Item Functioning and Discriminant Validity of the Fear of COVID-5 Scale Amidst Emerging Adult University Students in Mexico

The study aimed to perform confirmatory factor analysis, internal consistency, gender differential item functioning, and discriminant validity of the Fear of COVID-5 Scale in emerging adult students of a university in Mexico. Confirmatory factor analysis, internal consistency (Cronbach's alpha and McDonald's omega), and gender differential item functioning were estimated (Kendall tau b correlation). The Fear of COVID-5 Scale showed a one-dimension structure (RMSEA = 0.07, CFI = 0.98, TLI = 0.96, and SRMR = 0.02), with high internal consistency (Cronbach's alpha of 0.78 and McDonald's omega of 0.81), non-gender differential item functioning (Kendall tau b between 0.07 and 0.10), and significant discriminant validity (Higher scores for fear of COVID-19 were observed in high clinical anxiety levels). In conclusion, the Fear of COVID-5 Scale presents a clear one-dimension structure similar to a previous study.

Quality of life and depression in COPD patients in the Colombian Caribbean

OBJECTIVE

To establish the association between quality of life and depression among COPD patients of the Colombian Caribbean.

METHOD

A cross-sectional study was carried out with the participation of adult COPD patients. COPD-related quality of life was quantified with the COPD Assessment Test (CAT) and depression using the Zung 10-item Self-rating Depression Scale (SDS-10). The relationship between COPD-related quality of life and depression with odds ratios (OR), crude and adjusted, was determined.

RESULTS

408 patients participated in the study. They were aged between 40 and 102 years (mean = 72.9, SD = 10.2) and 58.8% men. Two hundred eighty-four patients (69.6%) reported worse health status (CAT ≥10), and 114 patients (27.9%) scored for depression (SDS-10). Patients with worse health status presented more depression (OR = 5.85, 95% CI 3.01-11.36) and after adjusting for gender (OR = 5.70, 95% CI 2.92-11.13).

CONCLUSIONS

In patients with COPD and CAT ≥10, there is a five times greater risk of depression than patients with CAT <10. However, the relationship may be bidirectional. It is essential to specify the direction of causality in future investigations.

Risk of a Major Depressive Episode in Asthma and COPD Patients Amidst Colombian SAR-CoV-2 Confinement

BACKGROUND

Chronic non-communicable diseases, such as asthma (AS) and chronic obstructive pulmonary disease (COPD), are a public health problem that compromises patients' quality of life and is highly comorbid with medical and psychological conditions. The present study's objective was to know the variables associated with the risk of major depression during confinement due to SAR-CoV-2 in patients with AS and COPD in the Colombian Caribbean.

SUBJECTS AND METHODS

An online cross-sectional observational study was done with the participation of patients diagnosed with AS or COPD. AS and COPD patients completed the Patient Health Questionnaire (PHQ-9) to identify a major depressive disorder risk.

RESULTS

Two hundred seventy-seven patients diagnosed with AS or COPD aged 18 to 69 (M=60.4, SD=17.6) participated. The risk of major depression was assessed using the PHQ-9 sent online after telephone contact with the participants. 30.7% of the patients during the last month reported a risk of major depression, and it was associated with a history of major depressive disorder (OR=4.39, 95% CI 1.53-12.67) and medical comorbidity (OR=1.69, 95% CI 1.00-2.86).

CONCLUSIONS

The depression risk is associated with a history of depressive disorder and medical comorbidity in patients with AS and COPD. Medical history is the leading risk factor for depression during confinement. It is recommended to carry out studies with many participants and study other variables that may mediate said associations during confinement by SAR-CoV-2 in the Colombian Caribbean.

Cigarette Smoking and Suicidal Behaviors in Colombian High-School Students

The study aimed to quantify the association between last-month cigarette smoking and lifetime suicide behaviors in high-school students at Santa Marta, Colombia. A cross-sectional study was designed in which high-school students participated. They were asked about last-month cigarette smoking and lifetime suicide behaviors (suicide ideation, plan, and attempt). Crude odds ratios (ORs) were calculated and adjusted for confounding variables. A total of 1,462 students participated and they were between 13 and 17 ( M = 14.4, SD = 0.8) years, and 60.3% girls. The last-month prevalence of cigarette smoking was 11.6%, lifetime suicide ideation 10.2%, plan 18.5%, and attempted 15.4%. Cigarette smoking was associated with suicide ideation (OR = 1.67, 95% confidence interval [CI] = [1.17, 2.41]), suicide plan (OR = 1.97, 95% CI = [1.33, 2.93]), and suicide attempt (OR = 2.79, 95% CI = [1.87, 4.17]), after adjusting for gender, family function, and depressive symptoms. In conclusion, cigarette smoking is related to suicide behaviors in high-school students at Santa Marta, Colombia.

Cultural psychiatry: beyond DSM-5

BACKGROUND

Cultural psychiatry evaluates manifestations, symptoms of emotional distress and mental disorders in diverse cultural contexts; it also addresses social problems such as poverty, violence, inequalities between groups or social classes.

OBJECTIVE

To present a narrative review of the most relevant cultural aspects in the context of clinical practice in psychiatry and to suggest some alternatives to improve the cultural competence of health care professionals.

METHOD

A narrative review was carried out of the most relevant articles in the area.

RESULTS

Usually, the cultural argument is used to explain differences in observed prevalences in some mental disorders according to gender and geographical location. Cultural differences modify the expression of emotional distress and this can reduce the accuracy and affect the reliability and validity of the current diagnostic classification used in psychiatry. The American Psychiatric Association, in the most recent classification, revised cultural syndromes but only included a limited number of situations. Consequently, medical education and psychiatry must respond to diverse populations and provide quality care through the development of trans-cultural competence in the curriculum.

CONCLUSIONS

It should be considered that cultural differences modify the expression of distress and thereby undermine the validity and reliability for diagnoses in distinct cultural contexts. In an increasingly globalised world, future classifications may completely omit 'cultural syndromes'.

The methodological quality is insufficient in clinical practice guidelines in the context of COVID-19: systematic review

Objectives

The number of published clinical practice guidelines related to COVID-19 has rapidly increased. This study explored if basic methodological standards of guideline development have been met in the published clinical practice guidelines related to COVID-19.

Study Design and Setting

Rapid systematic review from February 1 until April 27, 2020 using MEDLINE [PubMed], CINAHL [Ebsco], Trip and manual search, including all types of healthcare workers providing any kind of healthcare to any patient population in any setting.

Results

There were 1342 titles screened and 188 guidelines included. The highest average AGREE II domain score was 89% for scope and purpose, the lowest for rigor of development (25%). Only eight guidelines (4%) were based on a systematic literature search and a structured consensus process by representative experts (classified as the highest methodological quality). The majority (156; 83%) was solely built on an informal expert consensus. A process for regular updates was described in 27 guidelines (14%). Patients were included in the development of only one guideline.

Conclusion

Despite clear scope, most publications fell short of basic methodological standards of guideline development. Clinicians should use guidelines that include up-to-date information, were informed by stakeholder involvement, and employed rigorous methodologies.

Review of cases, case series and prevalence studies of zoophilia in the general population

BACKGROUND

Information about the frequency of zoophilic behaviour in the general population is scarce.

OBJECTIVE

To review cases, case series and prevalence studies of zoophilia in adults in the general population.

METHODS

A review of publications was carried out in MEDLINE via PubMed, Scopus and the Biblioteca Virtual en Salud [Virtual Health Library] ranging from January 2000 to December 2017.

RESULTS

Thirteen papers were reviewed (ten case reports, two case series and one cross-sectional study). Twelve patients were described, the case series totalled 1,556 people and the cross-sectional study included 1,015 participants and reported a prevalence of zoophilic behaviour of 2%.

CONCLUSIONS

Information on the prevalence of zoophilic behaviour in the general population is limited. The Internet will probably be a valuable tool for further investigating these behaviours in coming years.

Social capital and psychological distress during Colombian coronavirus disease lockdown

This study aimed to establish the association of low social capital (SC) with psychological distress indicators. A cross-sectional study was carried out using an online questionnaire that evaluated demographic variables, social capital, perceived stress related to coronavirus disease, depression risk, insomnia risk, and suicide risk. SC was taken as an independent variable, and symptoms indicating psychological distress were considered as dependent variables. A group of 700 adults aged between 18 and 76 years (M = 37, SD = 13) participated in the survey. Low SC was associated with depression risk (odds ratio [OR] = 2.00, 95% confidence interval [CI] = 1.34-2.97), elevated suicide risk (OR = 2.62, 95% CI = 1.40-4.91) high perceived stress related to coronavirus disease (OR = 2.08 95% CI, 1.15-3.76), and insomnia risk (OR = 2.42, 95% CI = 1.69-3.47). In conclusion, low CS was associated with indicators of psychological distress. SC is a community social resource that could help mitigate the quarantine impact of coronavirus disease amidst the Colombian population's psychological health.

Adaptation and psychometric evaluation of the Fear of COVID-19 Scale in the general Colombian population

The study aimed to adapt and explore the psychometric performance of the Fear of COVID-19 Scale (FCV-19S) in the general Colombian population. The original FCV-19S is a 7-item scale that underwent an adaptation (Item 1 and 5 were deleted). From an online sample of 1,687 adults (59% female), exploratory and confirmatory factor analyses were performed for versions of the scale with 6 and 5 items. Cronbach's alpha and McDonald's omega were calculated. The confirmatory factor analysis showed that the 5-item scale (Fear of COVID-5) presented better indicators. In conclusion, the Fear of COVID-5 has acceptable performance in the Colombian population.

COVID-19 vaccine distrust in Colombian university students: Frequency and associated variables

BACKGROUND AND AIM OF THE WORK

The frequency of distrust towards the COVID-19 vaccine varies widely depending on the context, way of measurement, and pandemic stage. However, little information is available about Colombian populations. The study aimed to know the frequency and variables associated with COVID-19 vaccine distrust in students of a Colombian university.

METHODS

A cross-sectional study was carried out which participated emerging adult students of a Colombian university.

RESULTS

A total of 1,136 students between 18 and 29 years (M= 22.0, SD = 3.0); most of participants were female (66.0%), non-health students (82.8%), low-income (79.0%), and residents of urban areas (84.9%). It was frequent low institutional trust (74.8%), low cognitive, social capital (27.9%), low fear of COVID-19 (49.5%), low perceived stress related to COVID-19 (83.5%), and high COVID-19 vaccine distrust (78.9%). Non-health carrier (Adjusted OR = 3.63, 95%CI 2.58-5.10), rural residence (AOR = 1.85, 95%CI 1.13-3.04), low income (AOR = 1.84, 95%CI 1.31-2.57), and perceived stress related to COVID-19 (AOR = 1.74, 95%CI 1.20-2.54) were related to high COVID-19 vaccine distrust.

CONCLUSIONS

COVID-19 vaccine distrust is high among emerging adult Colombian university students. The COVID-19 vaccine distrust is related to non-health science carriers, rural residents, low-income, and low-perceived stress related to COVID-19. The COVID-19 related health literacy should be improved in students of this university considering socio-cultural background.

Validity of the patient health questionnaire-2 (PHQ-2) for the detection of depression in primary care in Colombia

BACKGROUND

The PHQ-2 is a screening test for major depressive disorder (MDD) derived from PHQ-9, which has shown to be useful in the detection of cases of clinical significance in previous studies. The psychometric properties of PHQ-2 in the Colombian population are unknown.

METHODS

PHQ-2 were assessed in 243 patients in general medical consultations using the Mini-International Neuropsychiatric Interview (MINI) as the gold standard. Internal consistency, convergent validity and criterion validity were calculated by analyzing the Receptor Operating Characteristics (ROC) and the area under the curve (AUC).

RESULTS

Cronbach's alpha and McDonald's omega coefficients were 0.71. Spearman's rho coefficients for correlations with PHQ-9 and HADS-D scores were 0.63 and 0.59 (p<0.01). AUC was 0.89. The optimal cut point was ≥2 with the following indicators: sensitivity 0.87 specificity 0.74; Youden index 0.60; PPV 0.47; NPV 0.95; (LR+) 3.24; (LR-) 0.18 (95% CI 0.09-0.37). Kappa coefficient between PHQ-2 and MINI for depression was .458 and 0.46 for HADS-D.

LIMITATIONS

Since this study was done with people attending hospital, which could has implications for the prevalence of depression, affecting the validity indicators of the instrument.

CONCLUSIONS

PHQ-2 show an acceptable test performance in the context of the study. However, the test could yield a considerable amount of false positives that would require specialized evaluation to establish a reliable diagnosis.

Confirmatory Factor Analysis and Internal Consistency of the Suicidal Ideation Scale of the Center for Epidemiological Studies Depression Among Colombian Adolescents

The current study tested the one-dimensionality of the Center for Epidemiological Studies Depression Scale for Suicidal Ideation (CES-D-SI) and its reliability among high school students in Santa Marta, Colombia. A total of 1,462 tenth and eleventh-grade students from public and private schools completed the CES-D-SI. The students were between 13 and 17 years (M = 16.0, SD = 0.8), 60.3% were female, and 55.3% were in the tenth grade. A confirmatory factor analysis (CFA) was conducted, and the chi-square, root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TLI), and standardized root mean square residual (SRMR) statistics were calculated. The internal consistency of the dimension was calculated using Cronbach's alpha and McDonald's omega coefficients. The results of the CFA were as follows: chi-square = 26.51, df =2, p = .001; RMSEA = .092; 90% confidence interval = .063-.124; CFI = .983; TLI = .950; and SRMR = .019. Cronbach's alpha coefficient was .75, and McDonald's omega coefficient was .77. As conclusions, the scale exhibited a unidimensional structure similar to that in other studies and presented good reliability values. Hence, its use is recommended to screen suicidal ideation in school-aged adolescents in Santa Marta, Colombia.