Prevalence and Factors Associated With Suicide Ideation in Colombian Caribbean Adolescent Students

The study aimed to know the prevalence of and some factors associated with suicide ideation in high school adolescents from a Colombian Caribbean city. A cross-sectional analytical study was designed with probability sampling. An expected prevalence of 50% and an alpha error of 5% were estimated. High-school students from public and private institutions were invited to participate. One thousand four hundred sixty-two adolescents participated in, they were aged between 13 and 17 years, and 33.6% of students reported suicide ideation. Suicide ideation was associated with depression risk (OR = 4.54, 95% CI 2.35–8.77), family dysfunction (OR = 4.54, 95% CI 2.35–8.77), sexual violence (OR = 1.92 CI95% 1.33–2.76) and low academic achievement (OR = 1.97, 95% CI 1.42–2.73). It is concluded that 33.6% of adolescents enrolled in secondary education reported suicide ideation and was associated with depression risk, family dysfunction, sexual abuse, and poor academic achievement.

Polyvictimization and Recurrent Falling in Older Ecuadorian Adults: The Mediation Role of Depressive Symptoms

Objective: To assess depressive symptoms as a mediator in the association between polyvictimization and recurrent falling. Methods: Using data from the Salud, Bienestar y Envejecimiento (Health, Well-being, and Aging) Ecuador Study, we analyzed community-dwelling adults 60 years and older (n = 5227). Recurrent falling was determined as ≥2 falls during the prior 12 months. Polyvictimization was determined as a history of ≥2 types of abuse. The mediator was depressive symptoms. Mediation analyses were based on the VanderWeele method. Results: Polyvictimization was significantly associated with higher odds of recurrent falling, and odds ratio (OR) = 1.45 (95% confidence intervals [CI] 1.20-1.76). Higher depressive symptoms increase the odds for recurrent falling (OR = 1.09 and 95% CI 1.07-1.11). Moreover, depressive symptoms were a significant mediator between polyvictimization and recurrent falling. The mediating effect was 28.4%. Discussion: Polyvictimization was associated with higher odds of recurrent falling, and this association was mediated by depressive symptoms.

Barriers to access to mental health services among Colombia outpatients

BACKGROUND

Access barriers are all situations or conditions that limit seeking, receiving or enjoying benefits offered by the health system. This set of situations translates into underutilization of the services offered. In Colombia, there is little information about barriers to accessing medical care in general, and even less in the specific field of mental health.

AIM

To determine the barriers to accessing psychiatric care in outpatients in Santa Marta, Colombia.

METHODS

The authors designed a cross-sectional study with a non-probability sample of adult patients who consulted between August and December 2018. The barriers to access were measured with a 20-item version of the Barriers to Access to Care Evaluation (BACE) scale.

RESULTS

A total of 247 patients participated; they were between 18 and 82 years (mean (M) = 47.5, standard deviation (SD) = 13.9). A total of 69 (27.9%) patients classified as having major attitudinal barriers; 62 (25.1%) patients, major barriers related to stigma-discrimination; and 41 (16.6%) patients, major instrumental barriers. Concerning the associated variables, age less than 45 years was related to major attitudinal barriers (odds ratio (OR) = 2.9, 95% confidence interval (CI) 1.6-5.5), major barriers related to stigma-discrimination (OR = 3.8, 95% CI 2.0-7.2) and major instrumental barriers (OR = 2.7, 95% CI 1.3-5.3). Men reported major instrumental barriers more frequently than women (OR = 2.8, 95% CI 1.3-5.8).

CONCLUSION

The major attitudinal, related to stigma-discrimination and instrumental barriers to access frequently delay a consultation with mental health services. Actions are necessary to reduce barriers to accessing mental health care.

Consistencia interna y dimensionalidad del cuestionario breve para detectar intimidación escolar

Objetivo. Corroborar el desempeño psicométrico, la consistencia interna y la dimensionalidad del Cuestionario Breve de Detección de Intimidación Escolar (CBDIE). Método. Se diseñó un estudio de validación en el que participaron 350 estudiantes, entre los 10 y los 17 años (M = 13.3; DE = 1.8), 53.7% de género femenino. Se calcularon indicadores de consistencia interna (Kuder-Richardson, K-R, y omega de McDonald) para las tres subescalas del CBDIE. Resultados. La subescala de intimidación percibida mostró K-R de 0.55 y omega de McDonald de 0.58; la subescala de síntomas emocionales, 0.80 y 0.81; y la subescala de intimidación perpetrada, 0.41 y 0.33. No fue posible demostrar la dimensionalidad del instrumento. Conclusión. Solo la subescala de síntomas emocionales de CBDIE presenta alta consistencia interna. Se necesitan más investigaciones de la dimensionalidad del CBDIE, para dar cuenta de su estructura interna.

Dimensionalidad, validez nomológica y consistencia interna de la escala breve de Davidson para estrés postraumático en estudiantes de Santa Marta, Colombia

Objetivo: Conocer la dimensionalidad, la validez nomológica y la consistencia interna de la escala breve de Davidson para estrés postraumático en estudiantes de media vocacional de Santa Marta, Colombia. Metodología: En el segundo semestre de 2018, un total de 1462 estudiantes de décimo y undécimo grado, entre 13 y 17 años (M = 16,0; de = 0,8), 60,3 % de sexo femenino, diligenció la escala breve de Davidson para estrés postraumático. Se realizaron análisis factorial exploratorio y confirmatorio. Se calculó la consistencia interna de la dimensión, con los coeficientes alfa de Cronbach y omega de McDonald. Resultados: En el análisis factorial exploratorio, la escala breve de Davidson para estrés postraumático mostró Kaiser-Meier-Olkin = 0,714, chi cuadrado de Barttlet = 783,3 (gl = 6; p = 0,001), y valor propio de 1,99, que explicó el 49,7 % de la varianza. En el análisis factorial confirmatorio, chi cuadrado = 5,921; gl = 2; p = 0,052; raíz del cuadrado medio del error de aproximación = 0,037 (ic 90 % 0,000-0,072); índice comparativo de ajuste = 0,995; índice de Tucker-Lewis = 0,985 residual cuadrada media estandarizada = 0,011. El alfa de Cronbach fue 0,66, y la omega de McDonald, 0,69. Conclusiones: La escala breve de Davidson para estrés postraumático es unidimensional, con aceptable consistencia interna.

Suicide risk during the lockdown due to coronavirus disease (COVID-19) in Colombia

The study aimed to estimate the high suicide risk during the COVID-19 lockdown in the Colombian population. A total of 700 adults aged between 18 and 76 years (M = 37.1, SD = 12.7; 68.0% women) completed an online questionnaire. Findings showed that 7.6% of participants reported a high suicide risk. High suicide risk was associated with high perceived stress related to COVID-19, risk of depressive episode, and insomnia. Our study suggests that 1 out of 13 Colombians in a non-probability sample reports a high suicide risk during COVID-19. Findings need to be corroborated in a representative sample of Colombians.

Perceived stress associated with COVID-19 epidemic in Colombia: an online survey

This study aimed to assess the prevalence and variables related to perceived stress associated with the COVID-19 pandemic in a sample of Colombian adults using a designed online cross-sectional survey. Adults answered a version of the Perceived Stress Scale (PSS-10) modified for COVID-19 (PSS-10-C), with Cronbach alpha equal to 0.86. In total, 406 individuals aged between 19 and 88 years (M = 43.9; SD = 12.4) agreed to participate in the survey: 61.8% were females, 90.6% had a university degree, 44.1% were health professionals, and 45.7% considered public health policies for preventing the spread of the disease inconsistent with scientific recommendations. PSS-10-C scores ranged from 0 to 36 (M = 16.5; SD = 7.3); 58 individuals (14.3%) scored for high perceived stress (cut-off point = 25). The inconsistency between policies and scientific evidence was significantly related to high perception of stress associated with COVID-19 (OR = 2.36; 95%CI: 1.32-4.20), after adjusting for gender. We concluded that the study group presented the prevalence of perceived stress associated with COVID-19 at high levels, arising from the inconsistent strategies developed by health authorities in view of scientific recommendations. Further researches must address the psychosocial aspects of epidemics.

Los médicos generales y la salud mental en la pandemia por COVID-19

En lo corrido del milenio hemos sido testigos de varios desafíos para el orden social y la estabilidad de la comunidad en el ámbito de salud mental con el brote de enfermedades infecciosas1. El nuevo coronavirus (COVID-19) se extendió rápidamente, de China a más de 200 países y es responsable de una pandemia sin precedentes de neumonía aguda2.

Problemas de salud mental en la sociedad: un acercamiento desde el impacto del COVID 19 y de la cuarentena

La sociedad mundial vive una experiencia sin precedente, que moviliza todas las estructuras gubernamentales, sanitarias y sociales. Desde diciembre de 2019 a 15 de abril de 2020, la pandemia de coronavirus (COVID-19) se ha propagado a 213 países, con 1.848.439 casos confirmados en el contexto mundial y 676.162 en América Latina. En lo transcurrido del 6 de marzo hasta 15 de abril, en Colombia se informaron 3.105 casos y 131 muertes1.

Estructura factorial y consistencia interna de la escala de somnolencia de Epworth

Introducción. En comparación con la polisomnografía (PSG), la escala de somnolencia de Epworth (ESE) tiene propiedades clinimétricas limitadas, por tanto es necesario revisar su estructura factorial.Objetivo. Revisar la estructura factorial (dimensionalidad) y la consistencia interna de la ESE en un grupo de pacientes a los que se les realizó PSG en Santa Marta, Colombia.Materiales y métodos. Se realizó una investigación para medir las propiedades clinimétricas de la ESE. La muestra estuvo compuesta por 684 adultos entre 18 y 64 años (media=43.2, desviación estándar=13.4) que habían completado los 8 ítems de dicha escala. 440 eran hombres y 244, mujeres. Para probar la estructura factorial se usó el análisis factorial confirmatorio (AFC) y para computar la consistencia interna, los coeficientes omega de McDonald y alfa de Cronbach.Resultados. La estructura de factores fue unidimensional y explicó el 42% de la varianza. En cuanto al AFC, los coeficientes de bondad de ajuste fueron insatisfactorios: χ²=146.47 (gl=20, p=0.001), RMSEA=0.096 (IC90%: 0.082-0.111), CFI=0.902, TLI=0.863 y SMSR=0.047. Los coeficientes omega de McDonald y alfa de Cronbach fueron ambos de 0.80 (IC95%: 0.78-0.82).Conclusiones. La ESE presentó una estructura unidimensional limitada, por lo que es necesario revisar el constructo de somnolencia excesiva o refinar su estructura factorial, pues es posible que con ello se obtengan mejores indicadores en comparación con el mejor criterio de referencia para diagnosticar somnolencia diurna excesiva.

Confirmatory Factor Analysis Of The Family APGAR Questionnaire

INTRODUCTION

In Colombia, the family APGAR questionnaire is often used to evaluate family function. However, there is no confirmatory factor analysis (CFA) to corroborate the proposed one-dimensional structure in Colombian adolescent students.

OBJECTIVE

To perform CFA on the APGAR family questionnaire in high-school students of Santa Marta, Colombia.

METHOD

A total of 1462 students of tenth and eleventh grade of official and private schools completed the family APGAR questionnaire. Students between 13 and 17 years old (M=16.0, SD=0.8) were included, of which 60.3% were female, and 55.3% were tenth grade students. The χ2, RMSEA, CFI, TLI and SMSR were estimated in the CFA. The internal consistency of the dimension was calculated with Cronbach alpha and McDonald omega coefficients.

RESULTS

In the CFA the indexes were χ2=9.11, df=5, P=.105; RMSEA=.024 (CI90%, .000-.048), CFI=.998, TLI=.996, and SMSR=.009. Cronbach alpha coefficient was .819 and McDonald omega, .820.

CONCLUSIONS

The one-dimensional structure of the APGAR family scale is confirmed in high-school students of Santa Marta, Colombia. This questionnaire is reliable and valid for the measurement of family function in school-aged adolescents.

Depression, perceived stress related to COVID, post-traumatic stress, and insomnia among asthma and COPD patients during the COVID-19 pandemic

INTRODUCTION

The COVID pandemic has had a high psychological impact on healthy populations. Increased levels of perceived stress, depression, and insomnia are expected, especially in people with pre-existing medical conditions, such as asthma and chronic obstructive pulmonary disease (COPD), who seem to be particularly vulnerable. However, the difference in psychological distress frequency between asthma and COPD patients is unknown.

OBJECTIVE

To compare the prevalence of depression, perceived stress related to COVID, post-traumatic stress, and insomnia in asthma and COPD patients at a pulmonology clinic in Santa Marta, Colombia.

METHODS

A cross-sectional study was designed. The patients were contacted by telephone. An electronic link was sent to those who accepted. The questionnaire asked for perceived stress related to COVID-19, post-traumatic stress symptoms, depressive symptoms, and insomnia risk.

RESULTS

148 asthma patients and 144 COPD patients participated in, between 18 and 96 years. The prevalence of high COVID-19 perceived stress was 10.6% (n = 31); post-traumatic stress risk, 11.3% (n = 33); depression risk, 31.5% (n = 92); and insomnia risk, 57.7% (n = 169). No significant differences were found between asthma and COPD in indicators of psychological distress.

CONCLUSIONS

Asthma and COPD patients present similar frequencies of depression risk, COVID-19 perceived stress, post-traumatic stress risk, and insomnia risk during the Colombian lockdown. It is essential to evaluate and manage psychological distress among asthma and COPD patients. It can reduce the risk of exacerbation and improve the quality of life.

Suicide reporting in mass media in the state of Magdalena, Colombia

In 2016 and 2017, the suicide rate in Colombia went up from 5.20 to 5.72, respectively. The same trend was observed for the State of Magdalena for the same period with an increase in the rates that went from 3.37 in 2016 and 4.27 per one hundred thousand inhabitants in 20171,2. The suicide rate in the State of Magdalena occupies third place among the departments of the Colombian Caribbean region1

Association between attachment and suicidal risk in Colombian adolescent students

INTRODUCTION

Attachment is considered an important element in mental health, however, the relationship between attachment dimensions and suicidal risk has been little studied.

OBJECTIVE

To establish the association between trust, communication, and alienation and suicide risk in Colombian school adolescents.

SUBJECTS AND METHOD

A cross-sectional observational study with an analytical component was de signed in a randomized sample of 399 school adolescents (n = 1,901), according to a 30% prevalence of high suicide risk, members of the official educational institutions of Santa Marta (Colombia), the commune with the highest index of unsatisfied basic needs. Participants completed the Armsden & Greenberg attachment inventory and the Plutchik suicide risk scale, both validated locally. Reliability and association tests were calculated.

RESULTS

Adolescents were 339 adolescents between 13 and 19 years of age (M = 15.7, SD = 1.1), 57.8% were women. 59.9% of adolescents showed low trust in the mother, 57.2% low communication with the mother, 54.9% low alienation with the mother, 46.3%, low trust in the father, 49% low communication with the father, 48.7% low alienation with the father, and 28.6% high suicide risk. There was an association (adjusted) between high suicide risk and trust in the mother (OR = 2.00, 95%CI 1.12-3.57), communication with the mother (OR = 3.80, 95%CI 2.13-6.75), trust in the father (OR = 2.39, 95%CI 1.41-4.03), and communication with the father (OR = 2.01, 95%CI 1.19-3.37).

CONCLUSIONS

Low trust and low communication with mother and father are risk factors for high suicide risk in Colombian school adolescents. Further research on this association in other populations is needed, as well as to consider other mediating factors.

Asociación entre matoneo escolar, síntomas depresivos e ideación suicida

El objetivo de la presente investigación fue estimar la relación entre matoneo escolar (ME), síntomas depresivos con importancia clínica (SDIC) y alto nivel de ideación suicida (ANIS) en adolescentes estudiantes de la ciudad de Santa Marta, Colombia. Se diseñó un estudio transversal en el que participaron estudiantes entre 10 y 17 años, de sexto a undécimo grado escolar, quienes diligenciaron una versión de cinco ítems del Cuestionario de Intimidación Escolar Abreviado, CIE-A; la versión de diez ítems de la Escala del Centro de Estudios Epidemiológicos de la Depresión, CES-D-10; y la Escala de Okasha para Suicidalidad, EOS. Participaron 350 estudiantes (M=13,3; DE=1,8), 188 mujeres y 162 hombres, 236 estudiantes de básica secundaria y 114 en media vocacional. Un total de 58 (16,6%) informó ME, 59 (16,9%) SDIC y 33 (9,4%) ANIS. El ME se asoció significativamente a ANIS (OR=3,1; IC95% 1,3-7,9), después de controlar por SDIC y sexo. Se evidencia la relevancia de evaluar SDIC en víctimas de ME, y las posibilidades de reducir el riesgo de ANIS a partir de la identificación y realización de programas de intervención en adolescentes con SDIC.

Stigma-discrimination complex associated with major depressive disorder

Dear Editor:Throughout history, the stigma-discrimination complex (SDC) has been associated with serious mental disorders such as those on the spectrum of schizophrenia, where symptoms, side effects and impaired social functioning are difficult to conceal. (1) For its part, SDC related to major depressive disorder (MDD) is a growing phenomenon even though its clinical characteristics are easy to hide or are less evident in the social sphere (2,3); in these cases, said association may have more negative effects on people’s lives than the disorder itself. (4,5) Consequently, the Depression Stigma Scale (DSS) was designed to quantify the relationship between SDC and MDD (SDC-MDD). This is a Likert scale consisting of two subscales with nine items each. The first addresses the issue of attitude towards people who meet criteria for MDD, i.e. perceived stigma, and the second, the anticipated attitude for MDD, i.e. personal stigma or self-stigma. (6)

Relación entre el índice de masa corporal y la frecuencia de exacerbaciones en pacientes con enfermedad pulmonar obstructiva crónica en Santa Marta, Colombia

Introducción: El índice de masa corporal (IMC) se asocia inversamente a la frecuencia de exacerbaciones en pacientes con enfermedad pulmonar obstructiva crónica (EPOC); sin embargo, esta puede variar según el contexto. Objetivo: Cuantificar la asociación entre el IMC y la frecuencia de exacerbaciones en pacientes en Santa Marta, Colombia. Materiales y métodos: Estudio transversal de adultos con EPOC. Se calculó el IMC y la frecuencia de exacerbaciones se estimó a partir de la clasificación GOLD de estado global. Resultados: Participaron 292 pacientes entre 49 y 95 años; 61,6% eran hombres. Los IMC se observaron entre 12,8 y 40,2 (media=24,2; DE=4,5) distribuidos en 21 pacientes (7,2%) con desnutrición; 153 (52,4%), saludables; y 118 (40,4%), sobrepeso-obesidad. Un total de 146 pacientes (53,4%) se clasificaron GOLD A o B (exacerbaciones no frecuentes); y 136 pacientes (46,6%), GOLD C o D (exacerbaciones frecuentes). El 85,7% de los pacientes con desnutrición presentaron exacerbaciones frecuentes comparado con 51,6% en pacientes con peso saludable y 33,1% en pacientes con sobrepeso-obesidad (OR=0,18; IC95% 0,05-0,66 para peso saludable y OR=0,08; IC95% 0,02-0,29 para sobrepeso-obesidad frente a desnutrición). Conclusiones: El IMC presenta una relación inversa con la frecuencia de exacerbaciones en pacientes con EPOC de Santa Marta, Colombia.

Entrevistas en los procesos de selección de estudiantes de medicina

Desde hace varias décadas, las entrevistas en los procesos de selección de estudiantes para las escuelas de medicina han sido repetidamente objeto de discusión. No obstante, se ha investigado muy poco sobre la utilidad de la entrevista clásica en la admisión de los futuros médicos1,2.

Trastornos por consumo de sustancias: entre las inequidades y el estigma

Las personas que reúnen criterios para trastornos por consumo de sustancias (TCS) con frecuencia son víctimas del complejo estigma-discriminación (CED), no sólo por parte de la sociedad general, sino también por profesionales de la salud y la presencia de autoestigma. No obstante, la relación de los TCS con factores biológicos predisponentes y condiciones sociales adversas se considera que estos son ‘autoinducidos’. Asimismo, se conoce que en los TCS se presentan cambios biológicos, psicológicos o del desarrollo que menoscaban la decisión de abandono y la persistencia en el consumo, a pesar de las consecuencias negativas físicas, emocionales y sociales. El CED relacionado con el TCS es un estresor que deteriora aún más la calidad de vida de las personas consumidoras y, al mismo tiempo, se configura como una barrera de acceso a servicios de salud. Es necesario diseñar e investigar la efectividad de estrategias para reducir el CED relacionado con TCS en diferentes poblaciones y contextos.