RESUMO

INTRODUCTION AND OBJECTIVES: Mental disorders are very prevalent in the general population. Despite this, it is estimated that only about a third of the people affected is able to recognise problems on their own and to access health services. The aim was to determine the factors associated with the lack of self-recognition of mental problems and disorders in the Colombian population. METHODS: The National Mental Health Survey (ENSM-2015) conducted in Colombia identified adults over 18 years that answered 'yes' to the question 'Have you had a mental problem or disorder?', had a positive score in mental disorders measured by the Composite International Diagnostic Interview (CIDI) 3.0, or in mental problems detected by the SRQ-20. A bivariate analysis, as well as a logistic regression, were performed with possible related variables. RESULTS: A sample of 10, 870 adults was obtained, of whom 12.25% (1332) had mental disorders and 30.2% (3282) had mental problems. Of those individuals with disorders and problems, 7.9% recognised themselves as affected. The variables associated with self-recognition of disorders or problems were, among others: being female (OR = 1.8; 95%CI, 1.4-2.3), family dysfunction (OR = 1.5; 95%CI, 1.2-2.0), to have experienced a traumatic event (OR = 1.8; 95%CI, 1.4-2.2), illegal substance consumption (OR = 0.5; 95%CI, 0.4-0.7), not being poor (OR = 1.9; 95%CI, 1.2-3.0), and not having chronic illnesses (OR = 1.6; 95%CI, 1.3-2.1). CONCLUSIONS: Self-recognition is of great relevance to improve access to care by adults. The results provide associated variables that allow planning interventions that can promote the recognition of mental problems or disorders in this population.

Assuntos

RESUMO

RESUMEN Introducción y objetivos: Los trastornos mentales son muy prevalentes en la población general; a pesar de ello, solo alrededor de un tercio reconoce que los tiene y accede a los servicios de salud. El objetivo es determinar los potenciales factores asociados con la falta de autorreconocimiento de trastornos y problemas mentales entre la población colombiana. Métodos: En la Encuesta Nacional de Salud Mental 2015 (ENSM 2015) realizada en Colombia, se recogieron las respuestas de los adultos mayores de 18 anos a la pregunta sobre si tenían algún problema o trastorno mental que hayan puntuado positivo en trastornos mentales medidos por el CIDI 3.0 o en problemas mentales detectados por el SRQ-20. Se realizó un análisis bivariable con posibles variables relacionadas y otro multivariable de regresión logística. Resultados: Se obtuvo una muestra de 10.870 adultos; el 12,25% (1.332) sufría trastornos y el 30,2% (3.282), problemas. Del total de personas con trastornos y problemas, el 7,9% se autorreconoció con ellos. Las variables asociadas con el autorreconocimiento de trastornos o problemas fueron: ser mujer (OR = 1,8; IC95%, 1,4-2,3), tener disfunción familiar (OR = 1,5; IC95%, 1,2-2,0), haber sufrido un evento traumático (OR = 1,8; IC95%, 1,4-2,2), consumir sustancias psicoactivas (OR = 0,5; IC95%, 0,4-0,7), no ser pobre (OR = 1,9; IC95%, 1,2-3,0) y tener enfermedades crónicas (OR = 1,6; IC95%, 1,3-2,1), entre otras variables asociadas. Conclusiones: El autorreconocimiento de los adultos es de gran relevancia para iniciar el acceso a la atención. Los resultados proveen variables asociadas que permiten planear intervenciones para promover el autorreconocimiento en esta población.

ABSTRACT Introduction and objectives: Mental disorders are very prevalent in the general population. Despite this, it is estimated that only about a third of the people affected is able to recognise problems on their own and to access health services. The aim was to determine the factors associated with the lack of self-recognition of mental problems and disorders in the Colombian population. Methods: The National Mental Health Survey (ENSM-2015) conducted in Colombia identified adults over 18 years that answered "yes' to the question 'Have you had a mental problem or disorder?', had a positive score in mental disorders measured by the Composite International Diagnostic Interview (CIDI) 3.0, or in mental problems detected by the SRQ-20. A bivariate analysis, as well as a logistic regression, were performed with possible related variables. Results: A sample of 10, 870 adults was obtained, of whom 12.25% (1,332) had mental disorders and 30.2% (3282) had mental problems. Of those individuals with disorders and problems, 7.9% recognised themselves as affected. The variables associated with self-recognition of disorders or problems were, among others: being female (OR = 1.8; 95%CI, 1.4-2.3), family dysfunction (OR= 1.5; 95%CI, 1.2-2.0), to have experienced a traumatic event (OR =1.8; 95%CI, 1.4-2.2), illegal substance consumption (OR = 0.5; 95% saCI, 0.4-0.7), not being poor (OR = 1.9; 95%CI, 1.2-3.0), and having chronic illnesses (OR= 1.6; 95%CI, 1.3-2.1). Conclusions: Self-recognition is of great relevance to improve access to care by adults. The results provide associated variables that allow planning interventions that can promote the recognition of mental problems or disorders in this population.

RESUMO

INTRODUCTION AND OBJECTIVES: Mental disorders are very prevalent in the general population. Despite this, it is estimated that only about a third of the people affected is able to recognise problems on their own and to access health services. The aim was to determine the factors associated with the lack of self-recognition of mental problems and disorders in the Colombian population. METHODS: The National Mental Health Survey (ENSM-2015) conducted in Colombia identified adults over 18 years that answered "yes' to the question 'Have you had a mental problem or disorder?', had a positive score in mental disorders measured by the Composite International Diagnostic Interview (CIDI) 3.0, or in mental problems detected by the SRQ-20. A bivariate analysis, as well as a logistic regression, were performed with possible related variables. RESULTS: A sample of 10, 870 adults was obtained, of whom 12.25% (1,332) had mental disorders and 30.2% (3282) had mental problems. Of those individuals with disorders and problems, 7.9% recognised themselves as affected. The variables associated with self-recognition of disorders or problems were, among others: being female (OR=1.8; 95%CI, 1.4-2.3), family dysfunction (OR=1.5; 95%CI, 1.2-2.0), to have experienced a traumatic event (OR=1.8; 95%CI, 1.4-2.2), illegal substance consumption (OR=0.5; 95%CI, 0.4-0.7), not being poor (OR=1.9; 95%CI, 1.2-3.0), and having chronic illnesses (OR=1.6; 95%CI, 1.3-2.1). CONCLUSIONS: Self-recognition is of great relevance to improve access to care by adults. The results provide associated variables that allow planning interventions that can promote the recognition of mental problems or disorders in this population.

RESUMO

Objetivo: Describir las características clínicas, demográficas, frecuencia, tipo de aislamientos microbiológicos y resistencia a los antimicrobianos de pacientes con neoplasias hematológicas que presentaron como complicación neutropenia febril en el Hospital Universitario de San Ignacio Métodos: Estudio descriptivo observacional, se tomaron datos de historias clínicas de los pacientes adultos hospitalizados en la Unidad de Hematología y Trasplante de Médula Ósea, que cumplieron criterios de neutropenia febril entre enero de 2013 y diciembre de 2014 Resultados: se recolectaron 345 episodios de neutropenia febril, correspondientes a 193 pacientes. Se documentó foco infeccioso en el 68,1% de los episodios, con aislamiento microbiológico en el 62.9% de los episodios, con predominio de bacilos gram negativos, en 63,7% de los casos, seguido por los cocos gram positivos en 27,9% y hongos en 4,9%. En cuanto a los mecanismos de resistencia, en los aislamientos Escherichia coli y Klebsiella peumoniae se encontró producción de Beta Lactamasas de Espectro Extendido (BLEEs) en 17,5 y 13,8%; Carbapenemasas tipo KPC en 1,25 y 2,8% respectivamente. En cuanto a Staphylococcus aureus, se encontró resistencia a meticilina en 6,8% de los aislamientos. Mortalidad asociada a infección en 16,5% de los casos. Conclusión: En pacientes con Neoplasias Hematológicas con neutropenia febril post quimioterapia en el Hospital Universitario de San Ignacio encontramos alta probabilidad de documentación de foco infeccioso, con predominio de microorganismos gram negativos, especialmente enterobacterias; con comportamiento similar en pacientes post trasplante de precursores hematopoyéticos.

Objective: To describe the demographic and clinical characteristics, as well as frequency and type of bacterial isolate and resistance patterns in patients with hematological neoplasms complicated by febrile neutropenia at San Ignacio University Hospital Methods: This is a retrospective observational study. Data were collected from medical records of adult patients admitted in the Hemato-oncology and Bone Marrow Transplant Unit. Inclusion criteria was presence of febrile neutropenia in the setting of a hematological neoplasm from January 2013 to December 2014. Results: 345 episodes of febrile neutropenia from 193 patients were studied. An infectious focus was identified in 68.1% of episodes, and a bacterial isolate was obtained in 62.9% of episodes. The predominant microorganisms were gram-negative rods, gram-positive cocci, and fungi with a frequency of 63.7%, 27.9%, and 4.9% respectively. In term of resistance patterns, Escherichia coli and Klebsiella peumoniae isolates had a frequency of ESBL susceptibility pattern of 17.5% and 13.8% respectively; and a frequency of KPC susceptibility pattern of 1.25% and 2.8% respectively. The frequency of methicillin resistant Staphylococcus aureus was 6.8%. Death associated to infection ocurred in 16.5% of episodes. Conclusions: In patients with hematological neoplasms complicated by febrile neutropenia at San Ignacio University Hospital, we found a high rate of documentation of infectious focus, with a predominance of gram-negative rods, specially Enterobacteriacea; with a similar pattern in receptors of hematopoietic stem cell transplantation.

Assuntos

RESUMO

INTRODUCTION: The prevalence of chronic conditions is increasing globally and this phenomenon covers pediatric populations. There is a relationship between chronic conditions and mental health problems, which has been insufficiently studied in the case of children. OBJECTIVE: To measure the frequency of problems and mental disorders in the Colombian population between 7 and 11 years, depending on the presence or absence of chronic conditions. METHODS: The information pertains to the National Survey of Mental Health of Colombia 2015, an observational cross-sectional nationally representative for the group between 7 and 11 years old. Mental problems where measure with the Reporting Questionnaire for Children (RQC), the 12 month prevalence of seven mental disorders were assessed using the Diagnostic Interview Schedule for Children Version parents (DISC-P) and a list of chronic conditions. Univariate and stratification analysis of the data were performed. RESULTS: 41.6% of the children with no chronic conditions, 56.7% of the children with 1 chronic condition and 70.8% in those with 2 or more have at least one RQC symptom; the highest prevalence of mental health symptoms are those with chronic inflammatory lung disease, followed by diabetes mellitus and allergies. The prevalence of one or more mental disorders in children without chronic conditions is 3.1% while those with at least 1 is 13.8%. CONCLUSIONS: A higher prevalence of mental disorders in children and its association with chronic conditions justifies further studies that address this issue and develop strategies with multidisciplinary interventions.

Assuntos

RESUMO

INTRODUCTION: The study of mental disorders in people with chronic conditions recognises the importance of actively seeking and treating both, since chronic conditions have a higher prevalence than mental disorders and their comorbidity generates greater burden than if each one was considered separately. OBJECTIVES: To measure the prevalence of mood disorders and anxiety in a Colombian population of 12 years and older and with and without different chronic conditions. METHODS: The information is taken from the National Mental Health Survey 2015 in Colombia, which was an observational cross-sectional study with national representativeness for the age groups measured 12-17, 18-44, and 45 and older. Disorders measured where mood disorders and anxiety social phobia, generalised anxiety disorder, and panic disorder in the past 12 months, and several chronic conditions. Univariate and bivariate analyses were performed for these conditions. RESULTS: The highest prevalence of mood and anxiety disorders were found in people with gastrointestinal diseases, followed by those with chronic pain, heart, and lung diseases, which corresponded to 27.1%, 13.3%, 12.2%, and 11.5%, respectively, in those between 18 and 44 years old, and 15.9%, 12.2%, 8.0%, and 7.4% of those 45 and older, respectively. This was greater than the prevalence of these mental disorders in people with no chronic condition, where the prevalence is 3.5% in the younger, and 1.1% in the older group. However, the risk of these mental disorders is higher in older people. Thus, in those with gastrointestinal diseases when compared to people of the same age without any chronic condition the prevalence is 14.9 times higher, but for the same disease in the younger group it is 7.8. CONCLUSIONS: These findings link chronic conditions with a higher prevalence of mental disorders, which in the present study also highlights the greater comorbidity of mood and anxiety disorders in the elderly.

Assuntos

RESUMO

INTRODUCTION: The 2015 National Mental Health Survey (NMHS) is the fourth mental survey conducted in Colombia, and is part of the National System of Surveys and Population Studies for health. METHODS: A narrative description is used to explain the background, references, the preparation, and characteristics of the 2015 NMHS. The 2015 NMHS and its protocol emerge from the requirements that support the national and international policies related to mental health. Together with the Ministry of Health and Social Protection, the objectives, the collection tools, the sample, and the operational plan are defined. The main objective was to obtain updated information about the mental health, mental problems and disorders, accessibility to health services, and an evaluation of health conditions. Participants were inhabitants from both urban and rural areas, over 7 years old, and in whom the comprehension of social determinants and equity were privileged. An observational cross-sectional design with national, regional and age group representativity, was used. The age groups selected were 7-11, 12-17, and over 18 years old. The regions considered were Central, Orient, Atlantic, Pacific, and Bogota. The calculated sample had a minimum of 12,080 and a maximum of 14,496 participants. CONCLUSIONS: A brief summary of the protocol of the 2015 NMHS is presented. The full document with all the collection tools can be consulted on the Health Ministry webpage.

Assuntos

RESUMO

INTRODUCTION: Population surveys on mental health are performed as part of the inputs required for the creation, implementation and evaluation of policies related to mental health, worldwide, and as an initiative of the World Health Organisation (WHO). was held The fourth National Survey of Mental Health (ENSM 2015) was carried out during the first half of 2015 on a representative sample of 2,727 children between 7 and 11 years of age, 1,754 adolescents, and 10, 870 adults who were selected throughout the country. OBJECTIVE: To describe the selection and definition of the tools used to measure mental health (including social cognition and violence), problems, mental disorders, and the evaluation of health states, as well as to describe the process used to develop the data collection tools finally used. RESULTS: The measurement of mental disorders in children was performed using the Diagnostic Interview Schedule for Children (DISC), and the Composite International Diagnostic Interview (CIDI) was used for adolescents and adults. For the remaining components evaluated in the survey, a search was conducted on the tools used at a national and international level. The selection of the toos used for the evaluation was based on the questions made by each tool, as well as the scientific validity that could be obtained from the results. In some cases the complete tool (as published) was used, in other cases the tools were constructed unifying parts of different ones, or questions were written based on the concepts or characteristics to be measured. Subsequently, a validation of content, concept and semantic of every tool was carried out, including the CIDI and DISC. The resulting tools were used on a group of people with different characteristics. It was noted that further clarification was necessary for some people to fully understand what was being asked. Because the collection of all the information in the survey would be computer assisted, a stream format was generated to guide the implementation in Blaise software, after the creation and wording of each tool in order to review the validation process of the survey and to ensure the integrity in the order of questions and their format. Fictitious cases were generated during the process, and volunteers participated in the testing. CONCLUSIONS: The tools for information collection used in the National Survey of Mental Health 2015 are presented.

Assuntos

RESUMO

Resumen Introducción: El estudio de trastornos mentales en personas con condiciones crónicas busca reconocer la importancia de buscarlos activamente y tratarlos, dado que las condiciones crónicas tienen mayor prevalencia de trastornos mentales y su comorbilidad genera una carga mayor que la suma de las que cada uno genera. Objetivos: Medir la prevalencia de trastornos del afecto y de ansiedad en la población colombiana de 12 años en adelante sin y con diferentes condiciones crónicas. Métodos: La información analizada corresponde a las observaciones de la Encuesta Nacional de Salud Mental 2015, que consideró un diseño de corte transversal con representatividad nacional y de los grupos de edad de 12-17, 18-44 y ≥ 45 años. Se miden los trastornos del afecto, además de fobia social, ansiedad generalizada y trastorno de pánico, además de diferentes condiciones crónicas. Todas las prevalencias corresponden a los últimos 12 meses. El análisis de resultados incluyó técnicas de tipo univariable y bivariable de estas condiciones, considerando el diseño de muestras complejas utilizado, es decir, los resultados que se presentan se extrapolan a la población colombiana en estudio. Resultados: Las personas con enfermedades del aparato gastrointestinal presentan la mayor prevalencia de trastornos del afecto o de ansiedad, seguidas de las que tienen dolor crónico o enfermedades cardiacas y pulmonares, con prevalencias del 27,1, el 13,3, el 12,2 y el 11,5% de los grupos de 18-44 años y el 15,9, el 12,2, el 8,0 y el 7,4% del ≥ 45 años mayor que la prevalencia de esos trastornos mentales en las personas sin ninguna condición crónica (el 3,5% del grupo más joven y el 1,1% de los mayores). Sin embargo, el riesgo de sufrir trastornos mentales es mayor para las personas de más edad; para los que tienen enfermedades gastrointestinales, la prevalencia es 14,9 veces la de las personas de la misma edad sin ninguna condición crónica, pero con la misma enfermedad es 7,8 veces la del grupo más joven. Conclusiones: Los hallazgos relacionan las condiciones crónicas con mayor prevalencia de trastornos mentales; en el presente estudio se resalta que son las personas de más edad quienes presentan la mayor comorbilidad.

Abstract Introduction: The study of mental disorders in people with chronic conditions recognises the importance of actively seeking and treating both, since chronic conditions have a higher prevalence than mental disorders and their comorbidity generates greater burden than if each one was considered separately. Objectives: To measure the prevalence of mood disorders and anxiety in a Colombian population of 12 years and older and with and without different chronic conditions. Methods: The information is taken from the National Mental Health Survey 2015 in Colombia, which was an observational cross-sectional study with national representativeness for the age groups measured 12-17, 18-44, and 45 and older. Disorders measured where mood disorders and anxiety social phobia, generalised anxiety disorder, and panic disorder in the past 12 months, and several chronic conditions. Univariate and bivariate analyses were performed for these conditions. Results: The highest prevalence of mood and anxiety disorders were found in people with gastrointestinal diseases, followed by those with chronic pain, heart, and lung diseases, which corresponded to 27.1%, 13.3%, 12.2%, and 11.5%, respectively, in those between 18 and 44 years old, and 15.9%, 12.2%, 8.0%, and 7.4% of those 45 and older, respectively. This was greater than the prevalence of these mental disorders in people with no chronic condition, where the prevalence is 3.5% in the younger, and 1.1% in the older group. However, the risk of these mental disorders is higher in older people. Thus, in those with gastrointestinal diseases when compared to people of the same age without any chronic condition the prevalence is 14.9 times higher, but for the same disease in the younger group it is 7.8. Conclusions: These findings link chronic conditions with a higher prevalence of mental disorders, which in the present study also highlights the greater comorbidity of mood and anxiety disorders in the elderly.

Assuntos

RESUMO

Resumen Introducción: La prevalencia mundial de condiciones crónicas está en aumento, y este fenómeno abarca a las poblaciones pediátricas. No se ha estudiado lo suficiente la interrelación entre las condiciones crónicas y los problemas de salud mentalen el caso de los niños. Objetivo: Medir la frecuencia de problemas y trastornos mentales en la población colombiana de 7-11 años en función de la presencia o ausencia de condiciones crónicas. Métodos: La información pertenece a la Encuesta Nacional de Salud Mental de Colombia 2015, un estudio observacional de corte transversal, con representatividad nacional para el grupo de 7-11 años. Se midieron los problemas mentales con el cuestionario de reporte de niños (RQC), la prevalencia en los últimos 12 meses de 7 trastornos mentales de interés en esta población utilizando el Diagnostic Interview Schedule for Children versión para padres (DISC-P), además de diferentes condiciones crónicas. Se realizó un análisis univariado y estratificado. Resultados: Fue positivo el RQC del 41,6% de los niños sin condiciones crónicas, el 56,7% de los niños con1yel 70,8% de los que tienen 2 o más; los que presentan la mayor prevalencia de síntomas son los que tienen enfermedad pulmonar inflamatoria crónica, seguidos de aquellos con diabetes mellitus y alergias. La prevalencia de uno o más de los trastornos mentales en los niños sin condiciones crónicas es del 3,1%, mientras que en los que tienen por lo menos 1 es del 13,8%. Conclusiones: Se encontró mayor prevalencia de problemas mentales en los niños con condiciones crónicas, lo que justifica profundizar en estudios que aborden este tema y diseñar estrategias de intervención multidisciplinarias para mitigar la dicotomía mente-cuerpo predominante en la práctica clínica.

Abstract Introduction: The prevalence of chronic conditions is increasing globally and this phenomenon covers pediatric populations. There is a relationship between chronic conditions and mental health problems, which has been insufficiently studied in the case of children. Objective: To measure the frequency of problems and mental disorders in the Colombian population between 7 and 11 years, depending on the presence or absence of chronic conditions. Methods: The information pertains to the National Survey of Mental Health of Colombia 2015, an observational cross-sectional nationally representative for the group between 7 and 11 years old. Mental problems where measure with the Reporting Questionnaire for Children (RQC), the 12 month prevalence of seven mental disorders were assessed using the Diagnostic Interview Schedule for Children Version parents (DISC-P) and a list of chronic conditions. Univariate and stratification analysis of the data were performed. Results: 41.6% of the children with no chronic conditions, 56.7% of the children with 1 chronic condition and 70.8% in those with 2 or more have at least one RQC symptom; the highest prevalence of mental health symptoms are those with chronic inflammatory lung disease, followed by diabetes mellitus and allergies. The prevalence of one or more mental disorders in children without chronic conditions is 3.1% while those with at least 1 is 13.8%. Conclusions: A higher prevalence of mental disorders in children and its association with chronic conditions justifies further studies that address this issue and develop strategies with multidisciplinary interventions.

Assuntos