RESUMO
Suicide and suicidal behaviors are a significant public health problem, for which several prevention modalities have been implemented. The identification and treatment of suicidal risk is a critical step in prevention, especially in primary health care, a level where most of the population consults. This article focuses fundamentally on the research on suicide risk in primary care by proposing an action guide for the assessment and management initial of suicide ideas and attempts.
Assuntos
Ideação Suicida , Tentativa de Suicídio , Humanos , Atenção Primária à Saúde , Fatores de RiscoRESUMO
Suicide and suicidal behaviors are a significant public health problem, for which several prevention modalities have been implemented. The identification and treatment of suicidal risk is a critical step in prevention, especially in primary health care, a level where most of the population consults. This article focuses fundamentally on the research on suicide risk in primary care by proposing an action guide for the assessment and management initial of suicide ideas and attempts.
Assuntos
Humanos , Tentativa de Suicídio , Ideação Suicida , Atenção Primária à Saúde , Fatores de RiscoRESUMO
Este trabajo resume los cambios en la psiquiatría clínica y el psicoanálisis y la medicina psicosomática en el siglo pasado, destacando a dos médicos chilenos, un internista y un psiquiatra que influenciaron profundamente al autor. Los Drs. Hernán Alessandri Rodríguez e Ignacio Matte Blanco fueron formadores de médicos no solo en la Facultad de Medicina de la Universidad de Chile, sino a nivel nacional e internacional, dejando su sello hasta hoy. El artículo recorre la historia de esa Facultad, así como de la Clínica Psiquiátrica Universitaria, cuyo primer director fue el Prof. Matte. Este fue también el promotor de la Asociación Psicoanalítica Chilena, admitida en agosto de 1949 como sociedad componente de la Asociación Psicoanalítica Internacional. Se revisan los antecedentes históricos del psicoanálisis freudiano y de la medicina psicosomática hasta la mitad del siglo XX, para luego analizar los desarrollos posteriores tanto de la psiquiatría clínica, del psicoanálisis post-freudiano y de la salud mental chilenas. Se concluye subrayando cómo las personalidades, sus vinculaciones familiares y el contexto socio-cultural marcan los avances y las dificultades de los progresos en salud.
Assuntos
Humanos , História do Século XX , Psiquiatria/história , Psicanálise/história , Medicina Psicossomática/história , ChileRESUMO
Este trabajo revisa el contexto histórico y los principales temas de Tótem y Tabú (Freud, 1913), para luego actualizar el intento de Freud de validar externamente las ideas psicoanalíticas con evidencia de la antropología cultural de su época. Se analizan las principales críticas contemporáneas a esa publicación, para luego revisar estudios posteriores, de autores tales como Kardiner, Roheim, Devereux, los psicólogos del Yo, así como desde una perspectiva kleiniana (Hinshelwood, 2001). Se discute la idea freudiana de ver al psicoanálisis como la ciencia básica de las ciencias sociales, versus la tesis más aceptada hoy de que una mirada psicoanalítica puede aportar a los estudios socio-culturales elementos importantes pero que deben complementarse con los conocimientos propios de esas disciplinas
This paper reviews the historical context and the principal subjects treated by Totem and Taboo (Freud, 1913). Then it analyzes the Freudian attempt to externally validate psychoanalytic ideas with data from cultural anthropology of those days. The contemporary reaction to his attempt are described, as well posterior psychoanalytic studies such as those from Kardiner, Roheim, Devereux, Ego psychologists, as well as more recent kleinian attempts (Hinshelwood, 2001). Freud oscillated between declaring psychoanalysis the fundament of social sciences, and the nowadays more accepted- idea that a psychoanalytic view can contribute to socio-cultural with significant ideas that have to be complemented with the insights gained with knowledge gathered with the methods from each of those disciplines
Assuntos
Humanos , Masculino , Feminino , Psicanálise/história , Religião e Psicologia , Ciências Sociais , Antropologia Cultural , SociologiaRESUMO
The suicide deaths increased worldwide and also in Chile in the last decade. Therefore, preventive programs are needed. This paper reviews the literature on school suicide prevention programs. Results show that few programs center in suicide as the primary target, and most do on related factors such as major depression. Nevertheless, some of them lower suicide ideation and behavior in the studied sample especially when they target several objectives and perform two or more interventions.
Las muertes por suicidio han aumentado a nivel mundial y especialmente en nuestro país en la última década. Por ello se hace necesario realizar un trabajo preventivo, principalmente en adolescentes. El presente trabajo tuvo como objetivo realizar una revisión de la literatura de los programas de prevención de suicidio en adolescentes escolares. Los resultados demostraron que son pocos los programas centrados en abordar el suicidio como objetivo principal sino que su foco son factores asociados, como por ejemplo la depresión mayor. Aún así, varios consiguen una disminución de la ideación y conducta suicida en la población estudiada, especialmente cuando implementan más de una intervención.
Assuntos
Humanos , Adolescente , Saúde do Adolescente , Educação em Saúde , Suicídio/prevenção & controle , Serviços Preventivos de SaúdeRESUMO
Suicide is a global public health and social problem. It has important emotional consequences for the relatives of the deceased, as well as economic and emotional consequences for the rest of the community. Herein lies the importance of the early detection of potential cases and of utilizing adequate interventions. The present protocol was organized as a way of standardizing and giving the appropriate hierarchy to all interventions practiced in patients with suicidal risk within Hospital del Salvador.
El suicidio es un problema social y de salud pública en todo el mundo. Acarrea importantes consecuencias emocionales para las personas cercanas al fallecido y también consecuencias económicas y emocionales para el resto de la comunidad. De ahí la importancia de detectar tempranamente los potenciales casos y utilizar intervenciones adecuadas. El presente protocolo se estructuró como una manera de estandarizar y jerarquizar las intervenciones entregadas a pacientes con riesgo suicida en el Hospital del Salvador.
Assuntos
Humanos , Serviço Hospitalar de Emergência , Tentativa de Suicídio/prevenção & controle , Unidade Hospitalar de Psiquiatria , Algoritmos , Protocolos Clínicos , Entrevista Psicológica , Medição de Risco/métodos , Encaminhamento e ConsultaRESUMO
Background: In Chile, there has been an increase in suicide rates from 1.1 to 2.6 per 100,000 among adolescents aged 10 to 14 years and from 4.4 to 8.9 per 100,000 among those aged 15 to 19 years Aim: To identify protective factors for suicidal ideation according to parenting styles, as described by Barber et al. Material and Methods: The relation between suicidal ideation and parenting styles was assessed in a random sample of 2,346 Chilean school attending adolescents aged 13 to 20 years old (59% women) from three cities: Antofagasta (Northern Chile, II Region), Santiago (Central, Metropolitan Region) and Concepción (Southern, VIII Region). Participants were tested with the Chilean adaptation of the Cross National Adolescents Program (CNAP) Plus questionnaire developed by Barber et al. The relation between suicidal ideation and parenting styles was assessed using regression analyses. Results: Correlations between suicidal ideation and parenting styles were mostly significant, yet weak. High odds ratios were observed among parents who had a strong psychological control, inconsistent control, lack of expression of affection and covered marital hostility. Conclusions: High adolescent self-esteem, a good relationship with parents, psychological parental autonomy, expression of physical affection, social support and paternal monitoring were protective factors against suicidal ideation.
Assuntos
Adolescente , Feminino , Humanos , Masculino , Adulto Jovem , Relações Pais-Filho , Poder Familiar , Autonomia Pessoal , Autoimagem , Apoio Social , Ideação Suicida , Chile , Modelos Logísticos , Razão de Chances , Suicídio/prevenção & controle , Fatores de TempoRESUMO
Se presenta un consenso de expertos sobre "La Espiritualidad y Religiosidad como Factor Protector en Mujeres Depresivas con Riesgo Suicida", que se obtuvo utilizando una metodología Delphi. Sus resultados se han organizado en cinco áreas enfocadas en aspectos referentes al diseño de una intervención espiritual/religiosa: a) encuadre; b) características yformación del interventor, c) elementos a resguardar, d) contenidos y e) fases. Se concluye que los aspectos espirituales y religiosos deben considerarse en cada caso, y que un acompañamiento en pacientes creyentes puede mejorar su evolución y prevenir nuevos episodios de de riesgo suicida. En algunos casos la religiosidad pudiera aumentar los montos de culpa, aumentando la severidad y complejidad del cuadro clínico.
This document presents the expert consensus produced by a working meeting in Santiago de Chile during 2010 about "The Spirituality and Religiosity as a protective factor in depressive women with Suicidal Risk". The consensus followed the steps suggested by Delphi methodology. Its results are organized in five areas referent to spiritual/religious interventions: a) setting, b) counselor training, c) elements, d) subjects covered, e) stages. The experts consulted concluded that spiritual and religious aspects need to be considerate in each case, and that in believers can improve progress and prevent relapses at suicidal risk. However in some cases religious can increase the amounts offault, amplifying the severity and complicating the evolution.
Assuntos
Humanos , Feminino , Religião , Tentativa de Suicídio , Risco , Espiritualidade , DepressãoRESUMO
BACKGROUND: In Chile, there has been an increase in suicide rates from 1.1 to 2.6 per 100,000 among adolescents aged 10 to 14 years and from 4.4 to 8.9 per 100,000 among those aged 15 to 19 years AIM: To identify protective factors for suicidal ideation according to parenting styles, as described by Barber et al. MATERIAL AND METHODS: The relation between suicidal ideation and parenting styles was assessed in a random sample of 2,346 Chilean school attending adolescents aged 13 to 20 years old (59% women) from three cities: Antofagasta (Northern Chile, II Region), Santiago (Central, Metropolitan Region) and Concepción (Southern, VIII Region). Participants were tested with the Chilean adaptation of the Cross National Adolescents Program (CNAP) Plus questionnaire developed by Barber et al. The relation between suicidal ideation and parenting styles was assessed using regression analyses. RESULTS: Correlations between suicidal ideation and parenting styles were mostly significant, yet weak. High odds ratios were observed among parents who had a strong psychological control, inconsistent control, lack of expression of affection and covered marital hostility. CONCLUSIONS: High adolescent self-esteem, a good relationship with parents, psychological parental autonomy, expression of physical affection, social support and paternal monitoring were protective factors against suicidal ideation.
Assuntos
Relações Pais-Filho , Poder Familiar , Autonomia Pessoal , Autoimagem , Apoio Social , Ideação Suicida , Adolescente , Chile , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Fatores de Tempo , Adulto Jovem , Prevenção do SuicídioRESUMO
Introduction: Bibliometry is the discipline that measures the bibliographic production in a given scientific area; in Chile there are few studies documenting the themes and trends in Mental health research. Method: A quantitative analysis is performed of the 992 papers published in the Abstracts Book in the SONEPSYN meetings between 2000 and 2009. The most productive groups are mentioned, and a classification of main research themes according to the index of the Tratado de Psiquiatría edited by Heerlein et al. Results: The most frequent themes were Affective Disorders, (14,3 percent), Liaison and General Hospital Psychiatry (8,6 percent), Epidemiology and Classification (6,6 percent), Validation and use of diagnostic and psychometric scales (5,6 percent), followed by antidepressant use and teaching with 1,2 percent each. Most presentations were prepared in university settings (48 percent) or in hospitals (35 percent), with a strong concentration in the Metropolitan Region (80,4 percent) and the VIII Region (8,3 percent). Conclusions: There is an increasing number of psychiatric papers presented from 2000 to 2009, with the Metropolitan Region of Santiago the area that present the higher number of research work (76,31 percent).There is a low number of collaborative research: 88,3 percent of the works were presented by a single institution. 9,6 percent (this is 59 papers) were presented by two, and 2,1 percent (13 papers) by three. Affective disorders were the most researched area; followed by use of antipsychotics and liaision, community, and child and adolescent psychiatry.
Introducción: La bibliometría es la disciplina que mide la producción bibliográfica en un área científica determinada y en Chile hay pocos estudios que documenten los temas y tendencias de la producción en Salud Mental. Método: Se hace un análisis cuantitativo de los 992 trabajos publicados en los libros de resúmenes de los Congresos entre los años 2000y 2009. Se describen los grupos más productivos, así como se clasifican los temas de acuerdo a los títulos de los trabajos, al índice del Tratado de Psiquiatría editado por Heerlein y Cols. Resultados: Los temas más frecuentes eran los del trastornos del ánimo (14,3 por ciento), psiquiatría de enlace y hospital general (8,6 por ciento), epidemiología y clasificación (6,6 por ciento), validación y aplicación de instrumentos diagnósticos y de medición psicológica (5,6 por ciento), y los menos frecuentes antidepresivos y docencia con 1,2 por ciento cada uno. La mayoría de las presentaciones correspondieron a centros universitarios (48 por ciento) u hospitalarios (35 por ciento), con una importante concentración en la Región Metropolitana (80,4 por ciento) y la VIII Región (8,3 por ciento). Conclusiones: Se observa un número creciente de presentaciones desde el año 2000 hasta el 2009, siendo la RM quien presenta el mayor número de investigaciones con un 76,31 por ciento, llama la atención la baja asociatividad en las presentaciones: un 88,3 por ciento de los trabajos fueron presentados por una sola institucion. 9,6 por ciento (o sea 59 trabajos) fueron presentados por dos, y 2,1 por ciento (13 trabajos) por tres instituciones.Los trastornos del ánimo son el sub-tema más analizado, seguido por antipsicóticos y psiquiatría de enlace, comunitaria e infanto-juvenil.