TY - JOUR T1 - Interventions to reduce the consequences of stress in physicians: A review and meta-analysis A1 - Regehr, Cheryl A1 - Glancy, Dylan A1 - Pitts, Annabel A1 - Leblanc, Vicki R. Y1 - 2014/// JF - Journal of Nervous and Mental Disease VL - 202 IS - 5 SP - 353 EP - 359 SN - 0000000000000 DO - 10.1097/NMD.0000000000000130 N2 - A significant proportion of physicians and medical trainees experience stress-related anxiety and burnout resulting in increased absenteeism and disability, decreased patient satisfaction, and increased rates of medical errors. A review and meta-analysis was conducted to examine the effectiveness of interventions aimed at addressing stress, anxiety, and burnout in physicians and medical trainees. Twelve studies involving 1034 participants were included in three meta-analyses. Cognitive, behavioral, and mindfulness interventions were associated with decreased symptoms of anxiety in physicians (standard differences in means [SDM], -1.07; 95% confidence interval [CI], -1.39 to -0.74) and medical students (SDM, -0.55; 95% CI, -0.74 to -0.36). Interventions incorporating psychoeducation, interpersonal communication, and mindfulness meditation were associated with decreased burnout in physicians (SDM, -0.38; 95% CI, -0.49 to -0.26). Results from this review and meta-analysis provide support that cognitive, behavioral, and mindfulness-based approaches are effective in reducing stress in medical students and practicing physicians. There is emerging evidence that these models may also contribute to lower levels of burnout in physicians. ER - TY - JOUR T1 - Healing medicine's future: Prioritizing physician trainee mental health A1 - Baker, Kathryn A1 - Sen, Srijan Y1 - 2016/// JF - AMA Journal of Ethics VL - 18 IS - 6 SP - 604 EP - 613 DO - 10.1001/journalofethics.2016.18.6.medu1-1606 N2 - In this article, we discuss current perceptions of the model physician and how these perceptions conflict with stressful realities of training environments and contribute to the staggering rates of burnout and depression faced by medical students and residents. We suggest a multi-tiered interventional approach to address these problems, with innovations for individual trainees, programs, institutions, and the health care system. Finally, we discuss the medical community's ethical obligations to ensure that it is appropriately and thoughtfully investing in the wellness of medicine's next generations of practitioners. ER - TY - JOUR T1 - Intervention to promote physicianwell-being, job satisfaction, and professionalism a randomized clinical trial A1 - West, Colin P. A1 - Dyrbye, Liselotte N. A1 - Rabatin, Jeff T. A1 - Call, Tim G. A1 - Davidson, John H. A1 - Multari, Adamarie A1 - Romanski, Susan A. A1 - Henriksen Hellyer, Joan M. A1 - Sloan, Jeff A. A1 - Shanafelt, Tait D. Y1 - 2014/// JF - JAMA Internal Medicine VL - 174 IS - 4 SP - 527 EP - 533 DO - 10.1001/jamainternmed.2013.14387 N2 - IMPORTANCE Despite the documented prevalence and clinical ramifications of physician distress, few rigorous studies have tested interventions to address the problem. OBJECTIVE To test the hypothesis that an intervention involving a facilitated physician small-group curriculum would result in improvement in well-being. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 74 practicing physicians in the Department of Medicine at the Mayo Clinic in Rochester, Minnesota, conducted between September 2010 and June 2012. Additional data were collected on 350 nontrial participants responding to annual surveys timed to coincide with the trial surveys. INTERVENTIONS The intervention involved 19 biweekly facilitated physician discussion groups incorporating elements of mindfulness, reflection, shared experience, and small-group learning for 9 months. Protected time (1 hour of paid time every other week) for participants was provided by the institution. MAIN OUTCOMES AND MEASURES Meaning inwork, empowerment and engagement in work, burnout, symptoms of depression, quality of life, and job satisfaction assessed using validated metrics. RESULTS Empowerment and engagement at work increased by 5.3 points in the intervention arm vs a 0.5-point decline in the control arm by 3 months after the study (P = .04), an improvement sustained at 12 months (+5.5 vs +1.3 points; P = .03). Rates of high depersonalization at 3 months had decreased by 15.5%in the intervention arm vs a 0.8% increase in the control arm (P = .004). This difference was also sustained at 12 months (9.6% vs 1.5%decrease; P = .02). No statistically significant differences in stress, symptoms of depression, overall quality of life, or job satisfaction were seen. In additional comparisons including the nontrial physician cohort, the proportion of participants strongly agreeing that their work was meaningful increased 6.3%in the study intervention arm but decreased 6.3% in the study control arm and 13.4%in the nonstudy cohort (P = .04). Rates of depersonalization, emotional exhaustion, and overall burnout decreased substantially in the trial intervention arm, decreased slightly in the trial control arm, and increased in the nontrial cohort (P = .03, .007, and .002 for each outcome, respectively). CONCLUSIONS AND RELEVANCE An intervention for physicians based on a facilitated small-group curriculum improved meaning and engagement in work and reduced depersonalization, with sustained results at 12 months… ER - TY - JOUR T1 - Síntomas de ansiedad y depresión en residentes de especialización médica con riesgo alto de estrés A1 - Sánchez, Miguel Jesús Betancourt A1 - Islas, Clara Lilia Rodríguez A1 - Escobar, Ivette Vallecillo A1 - Rico, Laura Estela Sánchez Y1 - 2008/10// PB - Elsevier Doyma JF - Psiquiatría Biológica VL - 15 IS - 5 SP - 147 EP - 152 DO - 10.1016/S1134-5934(08)76485-6 UR - https://www.sciencedirect.com/science/article/abs/pii/S1134593408764856 N2 - OBJETIVO Analizar los síntomas de depresión y ansiedad en residentes en especialización médica en áreas de atención crítica. MATERIAL Y MÉTODO Estudio observacional y analítico en 90 médicos residentes en áreas de atención de pacientes en estado crítico (grupo problema) y en áreas no críticas (grupo control). En forma confidencial se aplicó los instrumentos de Hamilton para identificar síntomas de ansiedad y depresión. Se utilizaron estadísticos de tendencia central, dispersión y proporción para la descripción de las variables. La comparación entre grupos se realizó con la prueba de la χ2 con un valor alfa de 0,05. RESULTADOS Se estudió a 90 médicos residentes con las escalas de Hamilton: 45 expuestos a estrés bajo (grupo control) y 45 expuestos a estrés alto (grupo problema); 39 (43%) médicos presentaron síntomas de ansiedad y 40 (44%), síntomas de depresión. El grupo problema tenía mayor probabilidad de presentar síntomas de ansiedad y depresión, tanto para el factor sexo (odds ratio [OR] = 1,25 y 1,99) como el estado civil (OR = 1,87 y 1,40). Pero sobre todo para factores exógenos, como grado de especialización (OR = 1,62 y 2,13) y especialmente exposición al estrés (OR = 1,31 y 3,03). CONCLUSIONES El estrés es el detonante de síntomas de ansiedad y depresión en residentes de especializaciones médicas sometidos a alto grado de estrés. En la génesis de los síntomas de ansiedad y depresión de los médicos residentes intervienen factores endógenos y exógenos. OBJECTIVE To analyze the presence of symptoms of anxiety symptoms and depression in resident physicians in areas of critical care. MATERIAL AND METHOD We performed an analytical, observational study in 90 medical residents working in areas attending critically-ill patients (problem group) and in areas attending non-criticallyill patients (control group). Hamilton scales were applied confidentially to identify symptoms of anxiety and depression. Statistical measures of central tendency, dispersion and proportions were used for descriptive variables. Comparison between groups was carried out with the χ2 test to an alpha value of 0.05. RESULTS Ninety medical residents were studied with the Hamilton scales. Forty-five were exposed to low stress (control group) and 45 to high stress (problem group). Thirty-nine residents (43%) showed anxiety symptoms and 40 (44%) had depression symptoms. The problem group showed a greater probability of experiencing symptoms of anxiety and depression in relation to factors such as sex (odds ratio [OR] = 1.25 and 1.99), and marital status (OR = 1.87 and 1.40), but mainly in relation to exogenous factors such as the degree of specialization (OR = 1.62 and 2.13) and especially to stress exposure (OR = 1.31 and 3.03). CONCLUSIONS Stress triggers symptoms of anxiety and depression in medical residents in high-stress specialties. Endogenous and exogenous factors intervene in the genesis of symptoms of anxiety and depression in medical residents. ER - TY - JOUR T1 - The Stress of Residency: A Review of the Literature A1 - Butterfield, Paula Y1 - 1988/// JF - Archives of internal medicine VL - 148 SP - 1428 EP - 1435 ER - TY - JOUR T1 - Prevalence of anxiety and depressive symptoms among medical residents in Tunisia: a cross-sectional survey A1 - Marzouk, Mehdi A1 - Ouanes-Besbes, Lamia A1 - Ouanes, Islem A1 - Hammouda, Zeineb A1 - Dachraoui, Fahmi A1 - Abroug, Fekri Y1 - 2018/// JF - BMJ Open VL - 8 IS - 7 SP - 1 EP - 7 DO - 10.1136/bmjopen-2017-020655 N2 - OBJECTIVE To assess the prevalence of anxiety and depressive symptoms and the associated risk factors among Tunisian medical residents. DESIGN Cross-sectional survey. SETTING Faculty of Medicine, Tunis. PARTICIPANTS All Tunisian medical residents brought together between 14 and 22 December 2015 to choose their next 6-month rotation. INTERVENTION The items of the Hospital Anxiety and Depression (HAD) questionnaire were employed to capture the prevalence of anxiety and/or depression among the residents. The statistical relationships between anxiety and depression (HAD score) and sociodemographic and work-related data were explored by Poisson regression. RESULTS 1700 out of 2200 (77%) medical residents (mean age: 28.5±2 years, female: 60.8%) answered the questionnaire. The mean working hours per week was 62±21 hours; 73% ensured a mean of 5.4±3 night shifts per month; and only 8% of them could benefit from a day of safety rest. Overall, 74.1% of the participating residents had either definite (43.6%) or probable (30.5%) anxiety, while 62% had definite (30.5%) or probable (31.5%) depression symptoms, with 20% having both definite anxiety and definite depression. The total HAD score was significantly associated with the resident's age (OR=1.014, 95% CI 1.006 to 1.023, p=0.001); female gender (OR=1.114, 95% CI 1.083 to 1.145, p<0.0001); and the heavy burden of work imposed on a weekly or monthly basis, as reflected by the number of night shifts per month (OR=1.048, 95% CI 1.016 to 1.082, p=0.03) and the number of hours worked per week (OR=1.008, 95% CI 1.005 to 1.011, p<0.0001). Compared with medical specialties, the generally accepted difficult specialties (surgical or medical-surgical) were associated with a higher HAD score (OR=1.459, 95% CI 1.172 to 1.816, p=0.001). CONCLUSION Tunisian residents experience a rate of anxiety/depression substantially higher than that reported at the international level. This phenomenon is worrying as it has been associated with an increase in medical errors, work dissatisfaction and attrition. The means of improving the well-being of Tunisian medical residents are explored, emphasising those requiring immediate implementation. ER - TY - JOUR T1 - Factors associated with burnout during emergency medicine residency A1 - Takayesu, James Kimo A1 - Ramoska, Edward A. A1 - Clark, Ted R. A1 - Hansoti, Bhakti A1 - Dougherty, Joseph A1 - Freeman, Will A1 - Weaver, Kevin R. A1 - Chang, Yuchiao A1 - Gross, Eric Y1 - 2014/// JF - Academic Emergency Medicine VL - 21 IS - 9 SP - 1031 EP - 1035 DO - 10.1111/acem.12464 N2 - © 2014 by the Society for Academic Emergency Medicine.Objectives: While the prevalence of burnout in practicing emergency physicians has been studied, little is known of the prevalence and risk factors in emergency medicine (EM) residents. The aim of this study was to assess the prevalence of burnout among EM residents and the individual-level factors associated with burnout. Methods: Eight EM residency programs were surveyed using the Maslach Burnout Inventory (MBI). Demographic data and data on job satisfaction and tolerance of uncertainty in clinical decision-making were collected using validated instruments. Results: Of 289 eligible residents, 218 completed the MBI (response rate = 75%). A total of 142 residents (65%) met the criteria for burnout. Complete data sets of the other instruments were obtained from 193 (response rate = 67%), and this group comprised our study population. Subjects having a significant other or spouse had a higher prevalence of burnout compared to single residents (60% vs. 40%, p = 0.002). Poor global job satisfaction (p < 0.0001), lack of administrative autonomy (p = 0.021), and lack of clinical autonomy (p = 0.031) correlated with burnout, as did intolerance of uncertainty (p = 0.015). Conclusions: Burnout is highly prevalent in EM residents. Interventions should be targeted at 1) improving resident autonomy in the emergency department where possible, 2) supervision and instruction on medical decision-making that may affect or teach individuals to cope with risk tolerance, and 3) social supports to reduce work-home conflicts during training. ER - TY - JOUR T1 - Residency schedule, burnout and patient care among first-year residents A1 - Block, Lauren A1 - Wu, Albert W. A1 - Feldman, Leonard A1 - Yeh, Hsin Chieh A1 - Desai, Sanjay V. Y1 - 2013/// JF - Postgraduate Medical Journal VL - 89 IS - 1055 SP - 495 EP - 500 SN - 2012131743 DO - 10.1136/postgradmedj-2012-131743 N2 - Background The 2011 US Accreditation Council for Graduate Medical Education (ACGME) mandates reaffirm the need to design residency schedules to augment patient safety and minimise resident fatigue. Objectives To evaluate which elements of the residency schedule were associated with resident burnout and fatigue and whether resident burnout and fatigue were associated with lower perceived quality of patient care. Methods A cross-sectional survey of first-year medicine residents at three hospitals in May-June 2011 assessed residency schedule characteristics, including hours worked, adherence to 2003 work-hour regulations, burnout and fatigue, trainee-reported quality of care and medical errors. Results Response rate was 55/76 (72%). Forty-two of the 55 respondents (76%) met criteria for burnout and 28/55 (51%) for fatigue. After adjustment for age, gender and residency programme, an overnight call was associated with higher burnout and fatigue scores. Adherence to the 80 h working week, number of days off and leaving on time were not associated with burnout or fatigue. Residents with high burnout scores were more likely to report making errors due to excessive workload and fewer reported that the quality of care provided was satisfactory. Conclusions Burnout and fatigue were prevalent among residents in this study and associated with undesirable personal and perceived patient-care outcomes. Being on a rotation with at least 24 h of overnight call was associated with higher burnout and fatigue scores, but adherence to the 2003 ACGME work-hour requirements, including the 80 h working week, leaving on time at the end of shifts and number of days off in the previous month, was not. Residency schedule redesign should include efforts to reduce characteristics that are associated with burnout and fatigue. ER - TY - JOUR T1 - Depressive symptoms in medical students and residents: A multischool study A1 - Goebert, D. A1 - Thompson, D. A1 - Takeshita, J. A1 - Beach, C. A1 - Bryson, P. A1 - Ephgrave, K. A1 - Kent, A. A1 - Kunkel, M. A1 - Schechter, J. A1 - Tate, J. Y1 - 2009/// JF - Academic Medicine VL - 84 IS - 2 SP - 236 EP - 241 N2 - BACKGROUND: This multisite, anonymous study assessed depressive symptoms and suicidal ideation in medical trainees (medical students and residents). METHOD: In 2003-2004, the authors surveyed medical trainees at six sites. Surveys included content from the Center for Epidemiologic Studies-Depression scale (CES-D) and the Primary Care Evaluation of Mental Disorders (PRIME-MD) (measures for depression), as well as demographic content. Rates of reported major and minor depression and of suicidal ideation were calculated. Responses were compared by level of training, gender, and ethnicity. RESULTS: More than 2,000 medical students and residents responded, for an overall response rate of 89{{}{%}{}}. Based on categorical levels from the CES-D, 12{{}{%}{}} had probable major depression and 9.2{{}{%}{}} had probable mild/moderate depression. There were significant differences in depression by trainee level, with a higher rate among medical students; and gender, with higher rates among women (χ = 10.42, df = 2, and P = .005 and χ = 22.1, df = 2, and P < .001, respectively). Nearly 6{{}{%}{}} reported suicidal ideation, with differences by trainee level, with a higher rate among medical students; and ethnicity, with the highest rate among black/African American respondents and the lowest among Caucasian respondents (χ = 5.19, df = 1, and P = .023 and χ = 10.42, df = 3, and P = .015, respectively). CONCLUSIONS: Depression remains a significant issue for medical trainees. This study highlights the importance of ongoing mental health assessment, treatment, and education for medical trainees. © 2009 Association of American Medical Colleges. ER - TY - JOUR T1 - Evaluation of the quality of life and general health of medical residents A1 - Senol, Yesim A1 - Daloglu, Mustafa A1 - Baysal, Ozge Doganavsargil A1 - Gurpinar, Erol Y1 - 2017/// PB - Indian Journal of Medical Specialities Trust JF - Indian Journal of Medical Specialities VL - 9 IS - 1 SP - 7 EP - 11 DO - 10.1016/j.injms.2017.11.005 N2 - Introduction This study was conducted to determine the mental health and quality of life (QoL) of residents receiving education in preclinical, internal medical, and surgical medical sciences at Akdeniz University Medical School (AUMS). The participants were compared according to their fields of specialization. Additional factors were also assessed. Method A total of 120 residents were chosen by drawing lots. The questionnaire used in the study encompassed personal characteristics and fields of specialization, and also included a general health questionnaire and the World Health Organization Quality of Life scale. T-tests, variation and regression analysis were used for statistical testing. Results Residents in surgical medical sciences had lower scores for QoL and mental health compared with those undergoing education in internal medical sciences and preclinical science (p < 0.05). Presence of a disease, engagement in sports, the proportion of freshmen to veterans, and long shifts were determined as factors affecting QoL. Conclusion Residents working in surgical medical sciences had lower QoL scores in the physical health and social and environmental relationships domains than those working in preclinical and internal medical sciences. An educational environment, high quality of education, and measures to improve working conditions may help increase the QoL of residents. ER - TY - JOUR T1 - The relationship between long working hours and depression among first-year residents in Japan A1 - Ogawa, Ryoko A1 - Seo, Emiko A1 - Maeno, Takami A1 - Ito, Makoto A1 - Sanuki, Masaru A1 - Maeno, Tetsuhiro Y1 - 2018/// PB - BMC Medical Education JF - BMC Medical Education VL - 18 IS - 50 SP - 1 EP - 8 DO - 10.1186/s12909-018-1171-9 N2 - BACKGROUND In Japan, some residents develop mental health problems. In previous studies, it was reported that long working hours might be a cause of stress reaction such as depression. There were some reports that compared residents with 80 or more working hours with those with less than 80 working hours. However, many residents are practically detained for extra-long time, designated as 100 h or more per week, for medical practice, training, self-study, etc. There have been few reports on extra-long hours of work. This study evaluated the working environment and the amount of stress experienced by first-year residents, and examined the relationship between long working hours and depression, especially in the group of extra-long working hours. METHODS The study included 1241 first-year residents employed at 250 training hospitals in 2011. A self-report questionnaire was administered at the beginning of the residency and 3 months later to collect data on demographics, depressive symptoms, and training conditions (e.g., duration of work, sleep, disposable time, and night shift). Depressive symptoms were rated using the Center for Epidemiologic Studies Depression Scale. RESULTS The mean duration of work per week was 79.4 h, with 97 residents (7.8%) working 100 h or more. At 3 months, clinically significant depressive symptoms were reported by 45.5% of residents working 100 or more h per week, which proportion was significantly greater than that for respondents working less than 60 h (P < 0.001). Multivariate logistic regression analysis showed that a working week of 80 to 99.9 h was associated with a 2.83 fold higher risk and 100 h or more was associated with a 6.96-fold higher risk of developing depressive symptoms compared with a working week of less than 60 h. CONCLUSION Working excessively long hours was significantly associated with development of depressive symptoms. Proper management of resident physicians' working hours is critical to maintaining their physical and mental health and to improve the quality of care they provide. ER - TY - JOUR T1 - Interspecies transmission and emergence of novel viruses: lessons from bats and birds A1 - Chan, Jasper Fuk-Woo A1 - To, Kelvin Kai-Wang A1 - Tse, Herman A1 - Jin, Dong-Yan A1 - Yuen, Kwok-Yung Y1 - 2013/// JF - Trends in microbiology VL - 21 IS - 10 SP - 544 EP - 555 DO - 10.1016/j.tim.2013.05.005 UR - https://europepmc.org/articles/PMC7126491 ER - TY - JOUR T1 - Quality of Life , Burnout , Educational Debt , Internal Medicine Residents A1 - West, Colin P A1 - Shanafelt, Tait D A1 - Kolars, Joseph C Y1 - 2011/// JF - Journal of American Medical Association VL - 306 IS - 9 SP - 952 EP - 960 ER - TY - JOUR T1 - Prevalence and correlates of depression, anxiety, and stress in medical residents of a Brazilian academic health system A1 - Pasqualucci, Paula Lage A1 - Damaso, Luciana Luccas Mendes A1 - Danila, Arthur Hirschfeld A1 - Fatori, Daniel A1 - Lotufo Neto, Francisco A1 - Koch, Vera Hermina Kalika Y1 - 2019/// JF - BMC Medical Education VL - 19 IS - 1 SP - 193 EP - 193 DO - 10.1186/s12909-019-1621-z UR - https://doi.org/10.1186/s12909-019-1621-z N2 - Several studies correlate medical residency with the occurrence of mental health disorders, Burnout Syndrome and quality of life impairment. It has been demonstrated that mental health disorders increase medical errors and lead to less effective patient care. Considering such context, this study aimed to evaluate the prevalence of anxiety, depression, stress and to identify its correlates with Burnout Syndrome and quality of life in a sample of medical residents and fellow physicians of the largest Brazilian academic health system. ER - TY - JOUR T1 - Emergency medicine resident well-being: Stress and satisfaction A1 - Hoonpongsimanont, W. A1 - Murphy, M. A1 - Kim, C. H. A1 - Nasir, D. A1 - Compton, S. Y1 - 2014/// JF - Occupational Medicine VL - 64 IS - 1 SP - 45 EP - 48 DO - 10.1093/occmed/kqt139 N2 - BackgroundEmergency medicine (EM) residents are exposed to many work-related stressors, which affect them both physically and emotionally. It is unknown, however, how EM residents perceive the effect of these stressors on their well-being and how often they use unhealthy coping mechanisms to manage stress.AimsTo evaluate EM residents' perceptions of stressors related to their overall well-being and the prevalence of various coping mechanisms.MethodsAn online survey instrument was developed to gauge resident stress, satisfaction with current lifestyle, stress coping mechanisms and demographics. A stratified random sample of EM residents from three postgraduate years (PGY-I, PGY-II and PGY-III) was obtained. Descriptive statistics and one-way analysis of variance were used to compare residents across PGY level.ResultsThere were 120 potential participants in each of the three PGYs. The overall response rate was 30% (109) with mean age of 30 and 61% were male. On a 0-4 scale (0 = completely dissatisfied), respondents in PGY-I reported significantly less satisfaction with lifestyle than those in PGY-II and III (mean rating: 1.29, 1.66 and 1.70, respectively; P < 0.001). There were no significant differences in mean ratings between PGYs on each of the other stress categories: work relationships (1.37), work environment (1.10) and response to patients (1.08). Residents reported exercise (94%), hobbies (89%) and use of alcohol (71%) as coping methods.ConclusionsResidents reported low satisfaction with current lifestyle. This dissatisfaction was unrelated to perceived work-related stress. Some undesirable coping methods were prevalent, suggesting that training programs could focus on promotion of healthy group activities. ER - TY - BOOK T1 - Encuesta Nacional de Salud Mental 2015 A1 - MINSALUD A1 - COLCIENCIAS Y1 - 2015/// SN - 9789588903200 ER - TY - JOUR T1 - Associations between relationship status and mental well-being in different life phases from young to middle adulthood A1 - Grundström, Jenna A1 - Konttinen, Hanna A1 - Berg, Noora A1 - Kiviruusu, Olli Y1 - 2021/// KW - Depressive symptoms KW - Follow-up study KW - Life course KW - Mental well-being KW - Relationship status KW - Self-esteem JF - SSM - Population Health VL - 14 DO - 10.1016/j.ssmph.2021.100774 L1 - file:///D:/Descargas/1-s2.0-S2352827321000495-main.pdf N2 - The aim of this study was to assess the associations between relationship status and mental well-being in four different phases during the life course, and to identify whether relationship quality moderated these associations. We used a broader concept of relationship status (instead of marital status) and also included the positive dimension of mental health. Participants in a Finnish cohort study were followed up at ages 22 (N = 1,656), 32 (N = 1,471), 42 (N = 1,334), and 52 (N = 1,159). Measures in all study panels covered relationship status (marriage, cohabitation, dating, single and divorced/widowed), Short Beck Depression Inventory (S-BDI), self-esteem (seven items) and relationship quality (six items). Analyses were carried out using linear regression. Compared to marriage, being single or being divorced/widowed were associated with depressive symptoms at every age in men. For women, in turn, being single – but not being divorced/widowed – was associated with depressive symptoms. Among men, being single or being divorced/widowed were also associated with lower self-esteem at age 32, 42 and 52, but in women, only one association between lower self-esteem and being single was found at age 32. Of the age stages, the age 32 is highlighted in men, at which point all relationship statuses were risk factors compared to marriage. There were only few indications of the moderating role of the relationship quality. Compared to marriage, being single or being divorced/widowed were quite consistently associated with poorer mental well-being during the life course, especially among men. For dating and cohabiting the associations were more fragmented depending on age and gender; particularly among women, these relationship statuses tended not to differ from marriage in terms of mental well-being. These observations on mental well-being across five relationship statuses are important in our contemporary society, where the number of marriages is decreasing, and other forms of relationships are becoming more common. ER - TY - JOUR T1 - Prevalence of depression and depressive symptoms among resident physicians a systematic review and meta-analysis A1 - Mata, Douglas A. A1 - Ramos, Marco A. A1 - Bansal, Narinder A1 - Khan, Rida A1 - Guille, Constance A1 - Di Angelantonio, Emanuele A1 - Sen, Srijan Y1 - 2015/// JF - JAMA - Journal of the American Medical Association VL - 314 IS - 22 SP - 2373 EP - 2383 DO - 10.1001/jama.2015.15845 N2 - IMPORTANCE Physicians in training are at high risk for depression. However, the estimated prevalence of this disorder varies substantially between studies. OBJECTIVE To provide a summary estimate of depression or depressive symptom prevalence among resident physicians. DATA SOURCES AND STUDY SELECTION Systematic search of EMBASE, ERIC, MEDLINE, and PsycINFO for studies with information on the prevalence of depression or depressive symptoms among resident physicians published between January 1963 and September 2015. Studies were eligible for inclusion if they were published in the peer-reviewed literature and used a validated method to assess for depression or depressive symptoms. DATA EXTRACTION AND SYNTHESIS Information on study characteristics and depression or depressive symptom prevalence was extracted independently by 2 trained investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using meta-regression. MAIN OUTCOMES AND MEASURES Point or period prevalence of depression or depressive symptoms as assessed by structured interview or validated questionnaire. RESULTS Data were extracted from 31 cross-sectional studies (9447 individuals) and 23 longitudinal studies (8113 individuals). Three studies used clinical interviews and 51 used self-report instruments. The overall pooled prevalence of depression or depressive symptoms was 28.8% (4969/17,560 individuals, 95% CI, 25.3%-32.5%), with high between-study heterogeneity (Q = 1247, τ2 = 0.39, I2 = 95.8%, P < .001). Prevalence estimates ranged from 20.9% for the 9-item Patient Health Questionnaire with a cutoff of 10 or more (741/3577 individuals, 95% CI, 17.5%-24.7%, Q = 14.4, τ2 = 0.04, I2 = 79.2%) to 43.2% for the 2-item PRIME-MD (1349/2891 individuals, 95% CI, 37.6%-49.0%, Q = 45.6, τ2 = 0.09, I2 = 84.6%). There was an increased prevalence with increasing calendar year (slope = 0.5% increase per year, adjusted for assessment modality; 95% CI, 0.03%-0.9%, P = .04). In a secondary analysis of 7 longitudinal studies, the median absolute increase in depressive symptoms with the onset of residency training was 15.8% (range, 0.3%-26.3%; relative risk, 4.5). No statistically significant differences were observed between cross-sectional vs longitudinal studies, studies of only interns vs only upper-level residents, or studies of nonsurgical vs both nonsurgical and surgical residents. CONCLUSIONS AND RELEVANCE In this systematic review… ER - TY - JOUR T1 - Physician wellness : preventing resident and fellow burnout A1 - Okanlawon, Toyin Y1 - 2018/// JF - American Medical Association SP - 1 EP - 15 ER - TY - JOUR T1 - Rates of medication errors among depressed and burnt out residents: Prospective cohort study A1 - Fahrenkopf, Amy M. A1 - Sectish, Theodore C. A1 - Barger, Laura K. A1 - Sharek, Paul J. A1 - Lewin, Daniel A1 - Chiang, Vincent W. A1 - Edwards, Sarah A1 - Wiedermann, Bernhard L. A1 - Landrigan, Christopher P. Y1 - 2008/// JF - Bmj VL - 336 IS - 7642 SP - 488 EP - 491 DO - 10.1136/bmj.39469.763218.BE N2 - To determine the prevalence of depression and burnout among residents in paediatrics and to establish if a relation exists between these disorders and medication errors. ER - TY - BOOK T1 - Abecé sobre la salud mental, sus trastornos y estigma A1 - Social, Colombia. Ministerio de Salud y Protección Y1 - 2014/// UR - https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/PP/abc-salud-mental.pdf ER - TY - GEN T1 - Salud mental: un estado de bienestar A1 - OMS Y1 - 2013/// UR - https://www.who.int/features/factfiles/mental_health/es/ ER - TY - BOOK T1 - DSM-5, MANUAL DIAGNÓSTICO Y ESTADÍSTICO DE LOS TRASTORNOS MENTALES A1 - Association, American Psychiatric ET - 5ta SN - 9788491103721 ER - TY - THES T1 - SÍNDROME DE DESGASTE PROFESIONAL (BURNOUT) EN MÉDICOS RESIDENTES. UNIVERSIDAD DEL ROSARIO. BOGOTÁ- COLOMBIA 2016. A1 - Barrios Anaya, Clara Ines A1 - Granja Rojas, Luis Pedro Y1 - 2017/// ER - TY - JOUR T1 - Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019 A1 - Lai, Jianbo A1 - Ma, Simeng A1 - Wang, Ying A1 - Cai, Zhongxiang A1 - Hu, Jianbo A1 - Wei, Ning A1 - Wu, Jiang A1 - Du, Hui A1 - Chen, Tingting A1 - Li, Ruiting A1 - Tan, Huawei A1 - Kang, Lijun A1 - Yao, Lihua A1 - Huang, Manli A1 - Wang, Huafen A1 - Wang, Gaohua A1 - Liu, Zhongchun A1 - Hu, Shaohua Y1 - 2020/// JF - JAMA network open VL - 3 IS - 3 SP - e203976 EP - e203976 DO - 10.1001/jamanetworkopen.2020.3976 N2 - Importance: Health care workers exposed to coronavirus disease 2019 (COVID-19) could be psychologically stressed. Objective: To assess the magnitude of mental health outcomes and associated factors among health care workers treating patients exposed to COVID-19 in China. Design, Settings, and Participants: This cross-sectional, survey-based, region-stratified study collected demographic data and mental health measurements from 1257 health care workers in 34 hospitals from January 29, 2020, to February 3, 2020, in China. Health care workers in hospitals equipped with fever clinics or wards for patients with COVID-19 were eligible. Main Outcomes and Measures: The degree of symptoms of depression, anxiety, insomnia, and distress was assessed by the Chinese versions of the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder scale, the 7-item Insomnia Severity Index, and the 22-item Impact of Event Scale-Revised, respectively. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes. Results: A total of 1257 of 1830 contacted individuals completed the survey, with a participation rate of 68.7%. A total of 813 (64.7%) were aged 26 to 40 years, and 964 (76.7%) were women. Of all participants, 764 (60.8%) were nurses, and 493 (39.2%) were physicians; 760 (60.5%) worked in hospitals in Wuhan, and 522 (41.5%) were frontline health care workers. A considerable proportion of participants reported symptoms of depression (634 [50.4%]), anxiety (560 [44.6%]), insomnia (427 [34.0%]), and distress (899 [71.5%]). Nurses, women, frontline health care workers, and those working in Wuhan, China, reported more severe degrees of all measurements of mental health symptoms than other health care workers (eg, median [IQR] Patient Health Questionnaire scores among physicians vs nurses: 4.0 [1.0-7.0] vs 5.0 [2.0-8.0]; P = .007; median [interquartile range {IQR}] Generalized Anxiety Disorder scale scores among men vs women: 2.0 [0-6.0] vs 4.0 [1.0-7.0]; P < .001; median [IQR] Insomnia Severity Index scores among frontline vs second-line workers: 6.0 [2.0-11.0] vs 4.0 [1.0-8.0]; P < .001; median [IQR] Impact of Event Scale-Revised scores among those in Wuhan vs those in Hubei outside Wuhan and those outside Hubei: 21.0 [8.5-34.5] vs 18.0 [6.0-28.0] in Hubei outside Wuhan and 15.0 [4.0-26.0] outside Hubei; P < .001). Multivariable logistic regression analysis showed participants from outside Hubei pro… ER - TY - JOUR T1 - HOW DEFINITION OF MENTAL HEALTHPROBLEMS CAN INFLUENCE HELPSEEKING IN RURAL AND REMOTECOMMUNITIES A1 - Fuller, Jeff A1 - Edwards, Jane A1 - Procter, Nicholas A1 - Moss, John Y1 - 2000/// JF - Aust. J. Rural Health VL - 8 SP - 148 EP - 153 DO - 10.1016/j.urology.2003.09.036 N2 - Objectives. To describe the use of complementary and alternative medicines (CAMs) among men with a family history of prostate cancer and to evaluate the relationship between selected sociodemographic and behavioral characteristics and the use of CAMs. Methods. Unaffected brothers of men diagnosed with prostate cancer were asked to participate in a short computer-assisted telephone interview. The survey focused primarily on the use of different vitamins, herbal supplements, and medications, some of which are marketed for prostate health or prostate cancer prevention. Results. A total of 111 men completed the survey, representing 66% of eligible study subjects. Of the 111 men, 61 (55%) reported currently taking some form of CAM, with 30% taking a vitamin or supplement purported to have prostate-specific benefits. The prevalence of CAM use generally increased with increasing age; however, men who were younger than their affected brother at the time of the diagnosis of prostate cancer were more likely to use CAMs than were older brothers. Conclusions. Most men with a family history of prostate cancer take vitamins and supplements, some of which are believed to prevent future cancer occurrence. The results of this study and others provide some insight into the determinants of potentially beneficial health behaviors in high-risk individuals. © 2004 Elsevier Inc. ER - TY - JOUR T1 - Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence A1 - Wang, Lisheng A1 - Wang, Yiru A1 - Ye, Dawei A1 - Liu, Qingquan Y1 - 2020/// JF - International Journal of Antimicrobial Agents VL - 55 IS - 6 SP - 105948 EP - 105948 DO - 10.1016/j.ijantimicag.2020.105948 N2 - COVID-19, the disease caused by SARS-CoV-2, is a highly contagious disease. The World Health Organization has declared the ongoing outbreak to be a global public health emergency. Currently, the research on SARS-CoV-2 is in its primary stages. Based on current published evidence, this review systematically summarizes the epidemiology, clinical characteristics, diagnosis, treatment and prevention of COVID-19. It is hoped that this review will help the public to recognize and deal with SARS-CoV-2, and provide a reference for future studies. ER - TY - RPRT T1 - Vías de transmisión del virus de la COVID-19: repercusiones para las recomendaciones relativas a las precauciones en materia de prevención y control de las infecciones A1 - OMS Y1 - 2020/// ER - TY - JOUR T1 - Signos, síndromes y enfermedades con nombre propio A1 - Gil Extremera, Blas Y1 - 2017/// JF - Educacion Medica SP - 1 EP - 4 DO - 10.1016/j.edumed.2017.03.020 N2 - A review is presented of the most common signs, syndromes and diseases bearing the name of their discoverers. Until imaging and non-invasive diagnostic procedures appeared by the second half of the 20th century, diagnosis was mainly established by anamnesis and physical examination of the patients by inspection, palpation, percussion, and auscultation. However, the unquestionable value of these findings should not relegate the clinical examination. Therefore, many signs of syndromes and disease have taken the name of their discoverers: Homan, Cushing, Fanconi, among others, are still current and useful despite the innovative diagnostic tools. ER - TY - JOUR T1 - The Neurobiology of Stress and Development A1 - Gunnar, Megan A1 - Quevedo, Karina Y1 - 2007/// JF - Annual Review of Psychology VL - 58 IS - 1 SP - 145 EP - 173 DO - 10.1146/annurev.psych.58.110405.085605 N2 - AbstractStress is a part of every life to varying degrees, but individuals differ in their stress vulnerability. Stress is usefully viewed from a biological perspective; accordingly, it involves activation of neurobiological systems that preserve viability through change or allostasis. Although they are necessary for survival, frequent neurobiological stress responses increase the risk of physical and mental health problems, perhaps particularly when experienced during periods of rapid brain development. Recently, advances in noninvasive measurement techniques have resulted in a burgeoning of human developmental stress research. Here we review the anatomy and physiology of stress responding, discuss the relevant animal literature, and briefly outline what is currently known about the psychobiology of stress in human development, the critical role of social regulation of stress neurobiology, and the importance of individual differences as a lens through which to approach questions about stress experiences ... ER - TY - JOUR T1 - Neuropathology of stress A1 - Lucassen, Paul J A1 - Pruessner, Jens A1 - Sousa, Nuno A1 - Almeida, Osborne F X A1 - Van Dam, Anne Marie A1 - Rajkowska, Grazyna A1 - Swaab, Dick F A1 - Czéh, Boldizsár Y1 - 2014/// JF - Acta Neuropathologica VL - 127 IS - 1 SP - 109 EP - 135 DO - 10.1007/s00401-013-1223-5 N2 - Environmental challenges are part of daily life for any individual. In fact, stress appears to be increasingly present in our modern, and demanding, industrialized society. Virtually every aspect of our body and brain can be influenced by stress and although its effects are partly mediated by powerful corticosteroid hormones that target the nervous system, relatively little is known about when, and how, the effects of stress shift from being beneficial and protective to becoming deleterious. Decades of stress research have provided valuable insights into whether stress can directly induce dysfunction and/or pathological alterations, which elements of stress exposure are responsible, and which structural substrates are involved. Using a broad definition of pathology, we here review the "neuropathology of stress" and focus on structural consequences of stress exposure for different regions of the rodent, primate and human brain. We discuss cytoarchitectural, neuropathological and structural plasticity measures as well as more recent neuroimaging techniques that allow direct monitoring of the spatiotemporal effects of stress and the role of different CNS structures in the regulation of the hypothalamic- pituitary-adrenal axis in human brain. We focus on the hypothalamus, hippocampus, amygdala, nucleus accumbens, prefrontal and orbitofrontal cortex, key brain regions that not only modulate emotions and cognition but also the response to stress itself, and discuss disorders like depression, post-traumatic stress disorder, Cushing syndrome and dementia. © 2013 Springer-Verlag Berlin Heidelberg. ER - TY - JOUR T1 - Medical student distress: Causes, consequences, and proposed solutions A1 - Dyrbye, Liselotte N A1 - Thomas, Matthew R A1 - Shanafelt, Tait D Y1 - 2005/// JF - Mayo Clinic Proceedings VL - 80 IS - 12 SP - 1613 EP - 1622 DO - 10.4065/80.12.1613 N2 - The goal of medical education is to graduate knowledgeable, skilful, and professional physicians. The medical school curriculum has been developed to accomplish these ambitions; however, some aspects of training may have unintended negative effects on medical students' mental and emotional health that can undermine these values. Studies suggest that mental health worsens after students begin medical school and remains poor throughout training. On a personal level, this distress can contribute to substance abuse, broken relationships, suicide, and attrition from the profession. On a professional level, studies suggest that student distress contributes to cynicism and sybsequently may affect students' care of patients, relationship with faculty, and ultimately the culture of the medical profession. In this article, we review the manifestations and causes of student distress, its potential adverse personal and professional consequences, and proposed Institutional approaches to decrease student distress. © 2005 Mayo Foundation for Medical Education and Research. ER - TY - JOUR T1 - Factors associated to depression and anxiety in medical students: a multicenter study A1 - Brenneisen Mayer, Fernanda A1 - Souza Santos, Itamar A1 - Silveira, Paulo S P A1 - Itaqui Lopes, Maria Helena A1 - De Souza, Alicia Regina Navarro Dias A1 - Campos, Eugenio Paes A1 - De Abreu, Benedita Andrade Leal A1 - Hoffman, Itágores A1 - Magalhães, Cleidilene Ramos A1 - Lima, Maria Cristina P A1 - Almeida, Raitany A1 - Spinardi, Mateus A1 - Tempski, Patricia Y1 - 2016/// JF - BMC Medical Education VL - 16 IS - 1 SP - 1 EP - 9 DO - 10.1186/s12909-016-0791-1 N2 - Background: To evaluate personal and institutional factors related to depression and anxiety prevalence of students from 22 Brazilian medical schools. Methods: The authors performed a multicenter study (August 2011 to August 2012), examining personal factors (age, sex, housing, tuition scholarship) and institutional factors (year of the medical training, school legal status, location and support service) in association with scores of Beck Depression Inventory (BDI) and State Trait Anxiety Inventory (STAI). Results: Of 1,650 randomly selected students, 1,350 (81.8 %) completed the study. The depressive symptoms prevalence was 41 % (BDI > 9), state-anxiety 81.7 % and trait-anxiety in 85.6 % (STAI > 33). There was a positive relationship between levels of state (r = 0,591, p < 0.001) and trait (r = 0,718, p < 0.001) anxiety and depression scores. All three symptoms were positively associated with female sex and students from medical schools located in capital cities of both sexes. Tuition scholarship students had higher state-anxiety but not trait-anxiety or depression scores. Medical students with higher levels of depression and anxiety symptoms disagree more than their peers with the statements "I have adequate access to psychological support" and "There is a good support system for students who get stressed". Conclusions: The factors associated with the increase of medical students' depression and anxiety symptoms were female sex, school location and tuition scholarship. It is interesting that tuition scholarship students showed state-anxiety, but not depression and trait-anxiety symptoms. ER - TY - JOUR T1 - Mental Health and the Covid-19 Pandemic A1 - Pfefferbaum, B A1 - North, C Y1 - 2020/// JF - nejm SP - 1 EP - 3 ER - TY - BOOK T1 - Encyclopedia of Psychopharmacology A1 - Stolerman, Ian A1 - Price, Lawrence Y1 - 2015/// JF - Encyclopedia of Psychopharmacology SN - 978-3-642-36173-9 N2 - Biomedicine, Pharmacology/Toxicology, Molecular Medicine and Biomedicine general ER - TY - JOUR T1 - Depression and Other Common Mental Disorders A1 - OMS Y1 - 2017/// JF - Global Health Estimates ER - TY - JOUR T1 - The MD Blues: Under-Recognized Depression and Anxiety in Medical Trainees A1 - Mousa, Omar Y A1 - Dhamoon, Mandip S A1 - Lander, Sarah A1 - Dhamoon, Amit S Y1 - 2016/// JF - PLoS ONE VL - 11 IS - 6 SP - 1 EP - 10 DO - 10.1371/journal.pone.0156554 N2 - Background Mental health disease is under recognized in medical professionals. Objective To screen medical students (MS), residents and fellows for major depressive disorder (MDD) and generalized anxiety disorder (GAD) under the new era of work hour reform with age-matched controls from a large representative cross-sectional survey. Methods We conducted an anonymous online survey at a medical university in 2013-2014. We incorporated the Patient Health Questionnaire 2 (PHQ-2) to screen for MDD and the generalized anxiety disorder scale (GAD-7) to screen for GAD, along with additional questions on life stressors and academic performance. We compared these results to age-matched controls from the National Health and Nutrition Examination Survey (NHANES) database. Results126 residents/fellows and 336 medical students participated voluntarily. 15.1% and 15.9% of postgraduates as well as 16.4% and 20.3% of MS screened positive for MDD and GAD, respectively. When compared to national estimates, the prevalence of a positive screen for MDD was over five-fold higher in medical trainees compared to age-matched controls (16% vs. 2.8%, p<0.0001). Similarly, the prevalence of a positive screen for GAD was over eightfold higher in medical trainees (19% vs. 2.3%, p<0.0001).The prevalence was consistently higher within age strata. 33.3% of postgraduates and 32% of MS believe there is a significant impact of depression or anxiety on their academic performance. For stress relief, one fifth of residents/fellows as well as MS reported alcohol use. Conclusions The stresses of medical education and practice may predispose trainees to psychopathological consequences that can affect their academic performance and patient care. The current study showed a significantly higher rate of MDD and GAD positive screens in medical trainees than the prevalence in an age-matched U.S. population, despite significant work hour reform for medical trainees. Increased awareness and support services are required at all levels of medical training. We propose that the ACGME and the Institute of Medicine may consider these findings when implementing future changes to work hour regulations. ER - TY - JOUR T1 - Mental Health of Young Physicians in China During the Novel Coronavirus Disease 2019 Outbreak A1 - Li, Weidong A1 - Frank, Elena A1 - Zhao, Zhuo A1 - Chen, Lihong A1 - Wang, Zhen A1 - Burmeister, Margit A1 - Sen, Srijan Y1 - 2020/// JF - JAMA network open VL - 3 IS - 6 SP - e2010705 EP - e2010705 DO - 10.1001/jamanetworkopen.2020.10705 ER - TY - JOUR T1 - COVID-19– Associated Psychiatric Symptoms in Health Care Workers: Viewpoint From Internal Medicine and Psychiatry Residents A1 - Sonja A. Rasmussen MS, John C. Smulian, M D Y1 - 2020/// JF - Psychosomatics IS - January SP - 19 EP - 21 DO - 10.1007/s00134-020-05991-x.Bizzarro N2 - The 2030 Agenda for Sustainable Development agreed by UN Member States in 2015 will drive global and national policies for the coming fifteen years. Arsenic will feature more prominently in this development agenda, both in terms of direct influence on the target for universal access to safe drinking water, and indirect impacts on the realization of other targets. For states to successfully track progress towards the new targets, surveillance and monitoring systems will need to be strengthened at national and sub-national levels. Development and strengthening of such systems will take many years, and will certainly still be in progress by the end of the Sustainable Development Goals in 2030. ER - TY - JOUR T1 - Depression A1 - Malhi, Gin S A1 - Mann, J John Y1 - 2018/// JF - the Lancet VL - 6736 IS - 18 SP - 1 EP - 13 DO - 10.1016/S0140-6736(18)31948-2 N2 - Major depression is a common illness that severely limits psychosocial functioning and diminishes quality of life. In Published Online 2008, WHO ranked major depression as the third cause of burden of disease worldwide and projected that the disease November 2, 2018 will rank first by 2030.1 In practice, its detection, diagnosis, and management often pose challenges for clinicians because of its various presentations, unpredictable course and prognosis, and variable response to treatment. ER - TY - JOUR T1 - Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. A1 - G.S., Malhi A1 - D., Bassett A1 - P., Boyce A1 - R., Bryant A1 - P.B., Fitzgerald A1 - K., Fritz A1 - M., Hopwood A1 - B., Lyndon A1 - R., Mulder A1 - G., Murray A1 - R., Porter A1 - A.B., Singh Y1 - 2015/// JF - Australian and New Zealand Journal of Psychiatry VL - 49 IS - 12 SP - 1 EP - 185 N2 - Objectives: To provide guidance for the management of mood disorders, based on scientific evidence supplemented by expert clinical consensus and formulate recommendations to maximise clinical salience and utility. Methods: Articles and information sourced from search engines including PubMed and EMBASE, MEDLINE, PsycINFO and Google Scholar were supplemented by literature known to the mood disorders committee (MDC) (e.g. books, book chapters and government reports) and from published depression and bipolar disorder guidelines. Information was reviewed and discussed by members of the MDC and findings were then formulated into consensus-based recommendations and clinical guidance. The guidelines were subjected to rigorous successive consultation and external review involving: expert and clinical advisors, the public, key stakeholders, professional bodies and specialist groups with interest in mood disorders. Results: The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders (Mood Disorders CPG) provide up-to-date guidance and ER - TY - JOUR T1 - Ansiedad y depresión en médicos residentes de la especialidad en Medicina Familiar A1 - Mascarúa-Lara, Eduardo A1 - Vázquez-Cruz, Eduardo A1 - Córdova-Soriano, José Arturo Y1 - 2014/// JF - Atención Familiar VL - 21 IS - 2 SP - 55 EP - 57 DO - 10.22201/facmed.14058871p.2014.2.47919 N2 - Objetivo: identificar la presencia de ansiedad y/o depresión en médicos residentes de la especialidad en Medicina Familiar (mrmf). Material y métodos: estudio observacional, descriptivo, transversal, prospectivo, realizado en mrmf de la unidad de medicina familiar (umf) no. 6 de Puebla, México. Muestra no aleatoria. Se evaluó la ansiedad utilizando el test de Hamilton, y la depresión con el test de Beck. El análisis se efectuó a través de estadística descriptiva. Resultados: se estudió a 56 residentes de Medicina Familiar, 41 (73.21%) del sexo femenino y 15 (26.79%) del masculino, con edad media de 30 años; 28 residentes (50%) estaban solteros al momento del estudio. Con relación a la ansiedad, se observaron 23 casos (41.1%), siendo la ansiedad leve la más frecuente con 9 casos (39.1%) en residentes de primer año. Respecto a la depresión, se identificaron 11 casos (19.7%) de depresión leve, encontrándose sobre todo en residentes de segundo año con 5 casos (45.4%), y en cuanto al estado civil, 6 (45.5%) eran solteros. Conclusiones: predominaron mrmf que no presentaron algún grado de ansiedad y/o depresión; de los residentes que presentaron algún trastorno del estado de ánimo, la ansiedad y la depresión leves fueron las más frecuentes. Un médico insatisfecho o desgastado otorga una atención médica limitada y distante. ER - TY - JOUR T1 - Estado actual de depresión y ansiedad en residentes de Traumatología y Ortopedia en una unidad de tercer nivel de atención médica A1 - Montiel-Jarquín, Álvaro José A1 - Torres-Castillo, María Eugenia A1 - Herrera-Velasco, Mario Gerardo A1 - Ahumada-Sánchez, Óscar Omar A1 - Barragán-Hervella, Rodolfo Gregorio A1 - García-Villaseñor, Arturo A1 - Loría-Castellanos, Jorge Y1 - 2015/// JF - Educacion Medica VL - 16 IS - 2 SP - 116 EP - 125 DO - 10.1016/j.edumed.2015.09.006 N2 - Introduction: Anxiety and depression are common disorders. In hospitals, stress, long hours and continuous demand for learning are crucial to developing them. Objective: to present the current state and risk factors for depression and anxiety in residents of Orthopedics-Traumatology. Material and methods: Cross-sectional study in residents of Orthopedics and Traumatology, we applied Hamilton questionnaire for depression and anxiety. The reliability was> 0.6 (Cronbach α) for both questionnaires. Descriptive statistics, frequencies, proportions, Fisher (relative risk) were used. Results: 31 residents, mean age 28.19 (25-31) + 1.47 year old; 93.5% male, 6.5% female; 12.9% were residents from the fourth year, 29% from third, 32.2% from second and 25.8% from first year; 67.7% without a partner, 54.8% originating from a different state, 61.9% living more than 6 months outside their family; 41.9% smoked, 41.9% consumed alcoholic beverages. Depression was mild in 16.1%, moderate in 22.5%, severe in 16.1%, very severe in 6.4%; anxiety was mild in 38.7%, moderate in 41.9%, and severe in 3.2%; both disorders were presented in 58%. Depression was present in 87.5% residents from first-year, 50% second year, 55.5% third year and 50% from fourth year; anxiety in all from the first year, 80% second year, 77.7% third year and 75% from the fourth year, change of address, staying longer than six months away from home, smoking and drinking alcohol were risk factors (RR> 1.0, 95% CI> 1.0). Conclusion: Depression and anxiety are highly prevalent among residents of Orthopedics, change of residence and alcohol intake are risk factors. ER - TY - JOUR T1 - Burnout, Perceived Stress, and Depression Among Cardiology Residents in Argentina A1 - Waldman, S A1 - Diez, J C L A1 - Linetzky, B A1 - Arazi, H C A1 - Guinjoan, S A1 - Grancelli, H Y1 - 2009/// JF - Academic Psychiatry VL - 33 IS - 4 SP - 296 EP - 301 ER - TY - JOUR T1 - PREVALENCIA DEL SÍNDROME DE BURNOUT EN EL PERSONAL ASISTENCIAL DE SALUD DEL SERVICIO URGENCIAS DE LA UNIDAD INTEGRADA DE SERVICIOS DE SALUD FONTIBÓN- SUBRED SUROCCIDENTE E.S.E Y DE LA UNIDAD INTEGRADA DE SERVICIOS DE SALUD ENGATIVÁ- SUBRED NORTE E.S.E DE A1 - Garcia Rueda, Lorena A1 - Jimenez Chavez, Maria de los Angeles A1 - Riaño Alarcon, Sulma Lilian A1 - Umbarila Cuitiva, Edgar alexander Y1 - 2018/// DO - 10.1017/CBO9781107415324.004 ER - TY - JOUR T1 - EL SÍNDROME DE DESGASTE PROFESIONAL EN LOS MÉDICOS DE ATENCIÓN PRIMARIA A1 - Foz Gil, Gloria Y1 - 2008/// ER - TY - GEN T1 - Mental health in the workplace A1 - OMS Y1 - 2019/// UR - https://www.who.int/mental_health/in_the_workplace/en/ ER - TY - JOUR T1 - SÍNDROME DE BURNOUT A1 - Saborio morales, Lachiner A1 - Hidalgo Murillo, Luis fernando Y1 - 2015/// JF - Medicina Legal de Costa Rica VL - 32 IS - 1 ER - TY - JOUR T1 - Prevalencia del síndrome de Burnout en residentes de especialidades médicas A1 - Jácome, Sandra Jimena A1 - Villaquiran-hurtado, Andrés A1 - García, Claudia Patricia A1 - Duque, Iván Leonardo Y1 - 2019/// VL - 10 IS - 1 SP - 1 EP - 12 ER - TY - JOUR T1 - Burnout and Doctors: Prevalence, Prevention and Intervention A1 - Kumar, Shailesh Y1 - 2016/// JF - Healthcare VL - 4 IS - 3 SP - 37 EP - 37 DO - 10.3390/healthcare4030037 N2 - Doctors are exposed to high levels of stress in the course of their profession and are particularly susceptible to experiencing burnout. Burnout has far-reaching implications on doctors; patients and the healthcare system. Doctors experiencing burnout are reported to be at a higher risk of making poor decisions; display hostile attitude toward patients; make more medical errors; and have difficult relationships with co-workers. Burnout among doctors also increases risk of depression; anxiety; sleep disturbances; fatigue; alcohol and drug misuse; marital dysfunction; premature retirement and perhaps most seriously suicide. Sources of stress in medical practice may range from the emotions arising in the context of patient care to the environment in which doctors practice. The extent of burnout may vary depending on the practice setting; speciality and changing work environment. Understanding dynamic risk factors associated with burnout may help us develop strategies for preventing and treating burnout. Some of these strategies will be reviewed in this paper. ER - TY - JOUR T1 - Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic A1 - Dimitriu, Mihai C T A1 - Pantea-Stoian, Anca A1 - Smaranda, Alexandru C A1 - Nica, Anca A A1 - Carap, Alexandru C A1 - Constantin, Vlad D A1 - Davitoiu, Ana M A1 - Cirstoveanu, Catalin A1 - Bacalbasa, Nicolae A1 - Bratu, Ovidiu G A1 - Jacota-Alexe, Florentina A1 - Badiu, Cristinel D A1 - Smarandache, Catalin G A1 - Socea, Bogdan Y1 - 2020/// JF - Medical Hypotheses VL - 144 IS - 109972 SP - 1 EP - 4 DO - 10.1016/j.mehy.2020.109972 N2 - Burnout is a state of physical or mental collapse caused by overwork or stress. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and patient care. The new COVID-19 pandemic has raised public health problems around the world and required a reorganization of health services. In this context, burnout syndrome and physical exhaustion have become even more pronounced. Resident doctors, and especially those in certain specialties, seem even more exposed due to the higher workload, prolonged exposure and first contact with patients. This article is a short review of the literature and a presentation of some considerations regarding the activity of the medical residents in a non-Covid emergency hospital in Romania, based on the responses obtained via a questionnaire. Burnout prevalence is not equal in different specialties. We studied its impact and imagine the potential steps that can be taken in order to reduce the increasing rate of burnout syndrome in the pandemics. ER - TY - RPRT T1 - Prevención del consumo de sustancias psicoactivas (SPA) A1 - social, Ministerio de salud y proteccion Y1 - 2019/// ER - TY - JOUR T1 - Boletín VESPA 2012 A1 - D.C., Alcaldía Mayor de Bogotá Y1 - 2012/// ER - TY - JOUR T1 - ESTUDIO NACIONAL DE CONSUMO DE SUSTANCIAS PSICOACTIVAS EN COLOMBIA - 2013 A1 - UNDOC A1 - Colombia, Observatorio de Drogas de A1 - social, Ministerio de salud y proteccion A1 - derecho, Ministerio de justicia y del Y1 - 2013/// ER - TY - JOUR T1 - Consumo de drogas entre los estudiantes de medicina: Una revisión de la literatura 1988-2013 A1 - Roncero, Carlos A1 - Egido, Angel A1 - Rodríguez-Cintas, Laia A1 - Pérez-Pazos, Jesús A1 - Collazos, Francisco A1 - Casas, Miguel Y1 - 2015/// JF - Actas Espanolas de Psiquiatria VL - 43 IS - 3 SP - 109 EP - 121 N2 - Consumo de drogas entre los estudiantes de medicina: Una revisión de la literatura 1988-2013 El consumo de drogas legales e ilegales entre los estu-diantes de medicina es un fenómeno parcialmente conocido. El objetivo de este trabajo es revisar la literatura interna-cional publicada, en los últimos 25 años, sobre el consumo de drogas legales e ilegales entre los estudiantes de medici-na. Se realizó una búsqueda sistemática en MEDLINE y LI-LACS. Se evaluaron 106 manuscritos, que incluían 88.413 estudiantes de medicina. Se validaron 74.001 cuestionarios que representan el 83,7% de respuestas. La metodología y rigurosidad no son homogéneas en todas las publicaciones. Existen muchas variaciones regionales, siendo América y Eu-ropa las zonas en las que se han realizado más trabajos. Con la excepción del alcohol, en algunas zonas de occidente, los estudiantes de medicina consumen menos que los estudian-tes universitarios en general y que la población general co-etánea. Los consumos son principalmente de alcohol (24%), tabaco (17,2%) y cannabis (11,8%). También el consumo de fármacos hipnosedantes es frecuente (9,9%). El uso de esti-mulantes es del 7,7%, de cocaína es del 2,1%, siendo el de opiáceos muy reducido (0,4%). En algunas zonas de Latinoa-mérica hasta el 14,1% consumen inhalantes. Los estudiantes de los últimos años de carrera consumen más. El consumo de drogas es superior en los varones respecto a las mujeres, ex-ceptuando los hipnosedantes. El consumo en estudiantes de medicina es un fenómeno que, por su prevalencia y posibles repercusiones, debe ser sistemáticamente evaluado. The use of legal and illegal substances by medical students is a phenomenon that is only partially known. The aim of this paper was to review the literature published internationally in the last 25 years about the use of legal and illegal substances by medical students. A systematic search was made of MEDLINE and LILACS. One hundred and six manuscripts were evaluated, which included a population of 88,413 medical students. We validated 74,001 questionnaires, which represented 83.7% of responses. The methodology and the rigor of its application are not the same in all the publications. There are many regional variations, most studies being made in America and Europe. With the exception of alcohol in some areas of the Western world, medical students use substances less than university students in general and the general population. The substances used are mainly alcohol (24%), t… ER - TY - JOUR T1 - Consumo de sustancias psicoactivas en profesionales de la salud (médicos y enfermeros) de dos IPS de primer nivel de atención en consulta externa de Bogotá A1 - Lara, Catalina A1 - Vargas, Gina Milena A1 - Salcedo, Alejandra Y1 - 2012/// JF - Revista Ciencias de la Salud VL - 10 IS - SPECIAL ISSUE SP - 87 EP - 100 ER - TY - JOUR T1 - Adicciones en la época de la COVID-19 A1 - Ponciano Rodríguez, María Guadalupe Y1 - 2020/// JF - Boletín sobre COVID-19 VL - 1 IS - 3 SP - 4 EP - 4 ER - TY - JOUR T1 - Is returning to work during the COVID-19 pandemic stressful? A study on immediate mental health status and psychoneuroimmunity prevention measures of Chinese workforce A1 - Tan, Wanqiu A1 - Hao, Fengyi A1 - McIntyre, Roger S A1 - Jiang, Li A1 - Jiang, Xiaojiang A1 - Zhang, Ling A1 - Zhao, Xinling A1 - Zou, Yiran A1 - Hu, Yirong A1 - Luo, Xi A1 - Zhang, Zhisong A1 - Lai, Andre A1 - Ho, Roger A1 - Tran, Bach A1 - Ho, Cyrus A1 - Tam, Wilson Y1 - 2020/// JF - Brain, Behavior, and Immunity VL - 87 IS - April SP - 84 EP - 92 DO - 10.1016/j.bbi.2020.04.055 N2 - This study aimed to quantify the immediate psychological effects and psychoneuroimmunity prevention measures of a workforce returning to work during the COVID-19 epidemic. Workforce returning to work was invited to complete an online questionnaire regarding their attitude toward the COVID-19 epidemic and return-to-work along with psychological parameters including the Impact of Event Scale-Revised, Depression, Anxiety, Stress Scale- 21 (DASS-21) and Insomnia Severity Index (ISI). Psychoneuroimmunity prevention measures include precautions at personal and organization levels. From 673 valid questionnaires, we found that 10.8% of respondents met the diagnosis of post-traumatic stress disorder (PTSD) after returning to work. The respondents reported a low prevalence of anxiety (3.8%), depression (3.7%), stress (1.5%) and insomnia (2.3%). There were no significant differences in the severity of psychiatric symptoms between workers/technicians and executives/managers. >95% reported psychoneuroimmunity prevention measures including good ventilation in the workplace and wore a face mask as protective. Factors that were associated with the severity of psychiatric symptoms in the workforce were marital status, presence of physical symptom, poor physical health and viewing return to work as a health hazard (p < 0.05). In contrast, personal psychoneuroimmunity prevention measures including hand hygiene and wearing face masks as well as organizational measures including significant improvement of workplace hygiene and concerns from the company were associated with less severe psychiatric symptoms (p < 0.05). Contrary to expectations, returning to work had not caused a high level of psychiatric symptoms in the workforce. The low prevalence of psychiatric symptoms could be due to confidence instilled by psychoneuroimmunity prevention measures before the resumption of work. Our findings would provide information for other countries during the COVID-19 pandemic. ER - TY - JOUR T1 - Psychosocial impact of COVID-19 A1 - Dubey, S A1 - Biswas, P A1 - Ghosh, R A1 - Chatterjee, S Y1 - 2020/// JF - Diabetes & Metabolic Syndrome: Clinical Research & Reviews IS - January ER - TY - JOUR T1 - Boletín de salud mental Conducta suicida Subdirección de Enfermedades No Transmisibles A1 - Social, Ministerio de Salud y Protección Y1 - 2018/// SP - 25 EP - 25 N2 - La conducta suicida es un conjunto de eventos complejos, que pueden afectar a personas de cualquier edad o condición; cuando se manifiesta como el suicidio consumado, tiene consecuencias devastadoras para el individuo, su familia y comunidad, y sus efectos son duraderos. Se encuentra asociada a diversos factores de riesgo que pueden ser intervenidos con acciones específicas que abarcan el espectro de la promoción de la salud mental, la prevención y atención a los problemas y trastornos mentales, involucrando a diferentes sectores e instituciones y a la sociedad civil, que permita evitar así los desenlaces fatales. Con este boletín se espera abordar el tema de manera integral y proporcionar a los actores del Sistema General de Seguridad Social en Salud, información que permita orientar las decisiones en salud mental, a nivel territorial y en los diferentes entornos donde se prestan servicios. También se quiere llegar a la comunidad en general, para que identifique cuáles son los grupos poblacionales vulnerables, los signos de alarma y cuáles son los mecanismos para la prevención de la conducta suicida. ER - TY - JOUR T1 - Investigaciones sobre ideación suicida en Colombia, 2010-2016 A1 - Salamanca-Camargo, Yenny A1 - Siabato, Elsa Fernanda Y1 - 2017/// JF - Pensando Psicología VL - 13 IS - 21 SP - 59 EP - 70 DO - http://dx.doi.org/10.16925/pe.v13i21.1714 ER - TY - GEN T1 - Suicide A1 - OMS Y1 - 2019/// UR - https://www.who.int/news-room/fact-sheets/detail/suicide ER - TY - JOUR T1 - La Salud Mental De Los Médicos: Implementación Del Programa Paime Commálaga A1 - Molina, Elma Avanesi Y1 - 2015/// N2 - Los médicos, al igual que el resto de la población, padecen enfermedades que deben ser diagnosticadas y tratadas. Y aunque sus conocimientos sobre las patologías puedan proveerles de herramientas que faciliten cierta prevención, en algunos casos están sometidos a un riesgo similar o incluso superior al resto de la población. ER - TY - JOUR T1 - Ideación suicida en estudiantes de medicina: prevalencia y factores asociados A1 - Pinzón-Amado, Alexander A1 - Guerrero, Sonia A1 - Moreno, Katherine A1 - Landínez, Carolina A1 - Pinzón, Julie Y1 - 2013/// JF - Revista Colombiana de Psiquiatria VL - 43 IS - SUPPL. 1 SP - 47 EP - 55 DO - 10.1016/j.rcp.2013.11.005 N2 - Introduction It is well documented that physicians have higher rates of suicide than the general population. This risk tends to increase even from the beginning of undergraduate training in medicine. There are few studies evaluating the frequency of suicidal behaviors in undergraduate medical students, particularly in Latin America. Objective To determine the lifetime prevalence and the variables associated with suicidal ideation and suicide attempts in a sample of medical students from the city of Bucaramanga, Colombia. Materials and methods An analytical cross-sectional observational study was conducted to determine the lifetime prevalence of suicidal ideation and suicide attempts in a non-random sample of medical students enrolled in three medical schools in Bucaramanga. A self-administered questionnaire was voluntarily and anonymously answered by the participants. Validated versions of the CES-D and CAGE scales were used to assess the presence of depressive symptoms and problematic alcohol use, respectively. A multivariate logistic regression model was generated in order to adjust the estimates of variables associated with the outcome «suicidal ideation in life». Results The study sample consisted of 963 medical students, of which 57% (n = 549) of the participants were women. The average age was 20.3 years (SD = 2.3 years). Having had at least one episode of serious suicidal ideation in their lifetime was reported by 15.7% (n = 149) of the students, with 5% (n = 47) of the students reported having made at least one suicide attempt. Having taken antidepressants during their medical training was reported by 13.9% (n = 131) of the students. The variables associated with the presence of suicidal ideation in the logistic regression model were: clinically significant depressive symptoms (OR: 6.9, 95% CI; 4.54-10.4), history of illicit psychoactive substance use (OR 2.8, 95% CI; 1.6-4.8), and perception of poor academic performance over the past year (OR: 2.2, 95% CI; 1.4-3.6). The logistic regression model correctly classified 85% of the subjects with a history of suicidal ideation. Conclusion Suicidal ideation is a frequently occurring phenomenon in medical students. Medical schools need to establish screening procedures for early detection and intervention of students with emotional distress and suicide risk. © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España, S.L. Todos los derechos reservados. ER - TY - JOUR T1 - Suicide risk and prevention during the COVID-19 pandemic Published A1 - Gunnell, David A1 - Appleby, Louis A1 - Arensman, Ella A1 - Hawton, Keith A1 - John, Ann A1 - Kapur, Nav A1 - Khan, Murad A1 - C O’Connor, Rory A1 - Pirkis, Jane A1 - Collaboration, COVID-19 Suicide Prevention Research Y1 - 2020/// JF - the Lancet VL - 7 N2 - Pathogenic viruses are viruses that can infect and replicate within human cells and cause diseases. The con- tinuous emergence and re-emergence of pathogenic viruses has become a major threat to public health. Whenever pathogenic viruses emerge, their rapid detection is critical to enable implementation of specific control measures and the limitation of virus spread. Further molecular characterization to better understand these viruses is required for the development of diagnostic tests and countermeasures. Advances in molecular biology techniques have revolutionized the procedures for detection and characterization of pathogenic viruses. The development of PCR-based techniques together with DNA sequencing technology, have provided highly sensitive and specific methods to determine virus circulation. Pathogenic viruses potentially having global catastrophic consequences may emerge in regions where capacity for their detection and characterization is limited. Development of a local capacity to rapidly identify new viruses is therefore critical. This article reviews the molecular biology of pathogenic viruses and the basic principles of molecular techniques commonly used for their detection and characterization. The principles of good laboratory practices for handling pathogenic viruses are also discussed. This review aims at providing researchers and laboratory personnel with an overview of the molecular biology of pathogenic viruses and the principles of molecular techniques and good laboratory prac- tices commonly implemented for their detection and characterization. 1. ER - TY - JOUR T1 - A brief measure for assessing generalized anxiety disorder: The gad-7 A1 - RL, Spitzer A1 - Kroenke, K A1 - JW, Williams A1 - Löwe, B Y1 - 2006/// JF - Archives of Internal Medicine VL - 166 IS - 10 SP - 1092 EP - 1097 N2 - The article reports on the development of a brief self-report scale to determine probable cases of generalized anxiety disorder (GAD). A criterion-standard study was conducted in 15 primary care clinics in the United States. It was observed that a seven-item anxiety scale (GAD-7) had good reliability, including construct, criterion, procedural and factorial validity. ER - TY - JOUR T1 - Validity of the generalized anxiety disorder-7 scale in an acute psychiatric sample A1 - Kertz, Sarah A1 - Bigda-Peyton, Joe A1 - Bjorgvinsson, Throstur Y1 - 2012/// JF - Clinical Psychology and Psychotherapy VL - 20 IS - 5 SP - 456 EP - 464 DO - 10.1002/cpp.1802 N2 - Generalized anxiety disorder (GAD) is one of the most prevalent psychiatric presentations; however, GAD has the lowest diagnostic reliability of the anxiety disorders and is poorly recognized in clinical practice. A more reliable assessment of GAD could lead to earlier detection and treatment of the disorder, which has an otherwise debilitating course and significant associated impairment. The 7-item GAD Scale (GAD-7) has shown promise as a measure with good clinical utility and strong psychometric properties in primary care and community settings but has yet to be assessed in acute psychiatric populations. This study examined the validity of the GAD-7 in a sample of 232 patients enrolled in a partial hospital programme. Patients completed a diagnostic interview and a battery of self-report measures before and after treatment. Findings suggest that the GAD-7 has good internal consistency and good convergent validity with worry, anxiety, depression and stress, and the measure was sensitive to change over the course of a short intensive cognitive-behavioural therapy partial hospital programme. However, the confirmatory analysis failed to support the hypothesized unidimensional factor structure; and although the GAD-7 demonstrated good sensitivity (83), specificity was poor (46) in identifying patients with GAD. Overall, the GAD-7 appears to be a valid measure of generalized anxiety symptoms in this sample, on the basis of good internal consistency, convergent validity and sensitivity to change, but does not perform well as a screener for GAD. © 2012 John Wiley & Sons, Ltd. ER - TY - JOUR T1 - Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population A1 - Löwe, Bernd A1 - Decker, Oliver A1 - Müller, Stefanie A1 - Brähler, Elmar A1 - Schellberg, Dieter A1 - Herzog, Wolfgang A1 - Herzberg, Philipp Yorck Y1 - 2008/// JF - Medical Care VL - 46 IS - 3 SP - 266 EP - 274 DO - 10.1097/MLR.0b013e318160d093 N2 - Background: The 7-item Generalized Anxiety Disorder Scale (GAD-7) is a practical self-report anxiety questionnaire that proved valid in primary care. However, the GAD-7 was not yet validated in the general population and thus far, normative data are not available. Objectives: To investigate reliability, construct validity, and factorial validity of the GAD-7 in the general population and to generate normative data. Research Design: Nationally representative face-to-face household survey conducted in Germany between May 5 and June 8, 2006. Subjects: Five thousand thirty subjects (53.6% female) with a mean age (SD) of 48.4 (18.0) years. Measures: The survey questionnaire included the GAD-7, the 2-item depression module from the Patient Health Questionnaire (PHQ-2), the Rosenberg Self-Esteem Scale, and demographic characteristics. Results: Confirmatory factor analyses substantiated the 1-dimensional structure of the GAD-7 and its factorial invariance for gender and age. Internal consistency was identical across all subgroups (α = 0.89). Intercorrelations with the PHQ-2 and the Rosenberg Self-Esteem Scale were r = 0.64 (P < 0.001) and r = -0.43 (P < 0.001), respectively. As expected, women had significantly higher mean (SD) GAD-7 anxiety scores compared with men [3.2 (3.5) vs. 2.7 (3.2); P < 0.001]. Normative data for the GAD-7 were generated for both genders and different age levels. Approximately 5% of subjects had GAD-7 scores of 10 or greater, and 1% had GAD-7 scores of 15 or greater. Conclusions: Evidence supports reliability and validity of the GAD-7 as a measure of anxiety in the general population. The normative data provided in this study can be used to compare a subject's GAD-7 score with those determined from a general population reference group. Copyright © 2008 by Lippincott Williams &Wilkins. ER - TY - JOUR T1 - Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool A1 - García-Campayo, J A1 - Zamorano, E A1 - Ruíz, M A A1 - Pardo, A A1 - Freire, O A1 - Pérez-Páramo, M A1 - López-Gómez, V A1 - Rejas, J Y1 - 2010/// JF - Health and Quality of Life Outcomes VL - 8 IS - 8 DO - 10.1016/s0924-9338(09)70771-0 N2 - Background: Generalized anxiety disorder (GAD) is a prevalent mental health condition which is underestimated worldwide. This study carried out the cultural adaptation into Spanish of the 7-item self-administered GAD-7 scale, which is used to identify probable patients with GAD. Methods: The adaptation was performed by an expert panel using a conceptual equivalence process, including forward and backward translations in duplicate. Content validity was assessed by interrater agreement. Criteria validity was explored using ROC curve analysis, and sensitivity, specificity, predictive positive value and negative value for different cut-off values were determined. Concurrent validity was also explored using the HAM-A, HADS, and WHO-DAS-II scales. Results: The study sample consisted of 212 subjects (106 patients with GAD) with a mean age of 50.38 years (SD = 16.76). Average completion time was 2’30’’. No items of the scale were left blank. Floor and ceiling effects were negligible. No patients with GAD had to be assisted to fill in the questionnaire. The scale was shown to be one dimensional through factor analysis (explained variance = 72%). A cut-off point of 10 showed adequate values of sensitivity (86.8%) and specificity (93.4%), with AUC being statistically significant [AUC = 0.957-0.985); p < 0.001]. The scale significantly correlated with HAM-A (0.852, p < 0.001), HADS (anxiety domain, 0.903, p < 0.001), and WHO-DAS II (0.696, p > 0.001). Limitations: Elderly people, particularly those very old, may need some help to complete the scale. Conclusion: After the cultural adaptation process, a Spanish version of the GAD-7 scale was obtained. The validity of its content and the relevance and adequacy of items in the Spanish cultural context were confirmed ER - TY - JOUR T1 - Estrés y Salud Mental en Estudiantes de Medicina: Relación con Afrontamiento y Actividades Extracurriculares Stress and Mental Health in Medical Students : Relation with Coping and Extracurricular Activities Introducción A1 - Lemos, Mariantonia A1 - Henao-Pérez, Marcela A1 - Lopez-Medina, Diana Y1 - 2018/// JF - iMedPub Journals VL - 24 IS - 2:3 SP - 1 EP - 8 DO - 10.3823/1385 ER - TY - JOUR T1 - Validation and utility of a self-report version of PRIME-MD: The PHQ Primary Care Study A1 - Spitzer, R L A1 - Kroenke, K A1 - Williams, J B W Y1 - 1999/// JF - Primary Care Companion to the Journal of Clinical Psychiatry VL - 2 IS - 1 SP - 31 EP - 31 N2 - The Primary Care Evaluation of Mental Disorders (PRIME-MD) arose as a screening instrument, but its clinical application has been restricted by its administration time. This criterion standard study was undertaken, between May 1997 and November 1998 to determine whether the self-administered PRIME-MD Patient Health Questionnaire (PHQ) is valid and useful for diagnosing mental disorders in primary care compared with the original clinician-administered -PRIME-M.D. Sixty-two primary care physicians (21 internal medicine, 41 family practice) assessed 3000 adult patients drawn from 8 U.S. primary care clinics. Of these, 585 patients were assessed by a mental health professional within 48 hours of completing the PHQ. Measures of outcome were PHQ diagnoses compared with diagnoses made independently by mental health practitioners, function status measures, disability days, health care utilization, and treatment/referral decisions. 825 (28%) of the 3000 patients and 170 (29%) of the 585 had a PHQ diagnosis. As with the original PRIME-MD, agreement between PHQ diagnoses and those made by mental health practitioners was good (for diagnosis of any 1 or more PHQ disorder, K = 0.65; overall accuracy, 85%; sensitivity, 75% specificity, 90%). Patients with PHQ diagnoses had more functional impairment and more disability days and used more-health care resources than did those without PHQ diagnoses (for all group main effects, p < .001). It took much less time, on average, for the physician to review the PHQ than to conduct the original PRIME-MD (< 3 min for 85% vs. 16% of the cases). In spite of the fact that 80% of physicians reported that they would find regular use of the PHQ helpful, new management actions were enacted or planned for only 117 (32%) of the 363 patients with 1 or more PHQ diagnoses previously unidentified. This study suggests that the PHQ has diagnostic validity equivalent to the original clinician-administered PRIME-MD while being more efficient to use. ?? Copyright 2000 Physicians Postgraduate Press, Inc. ER - TY - JOUR T1 - Utility of a New Procedure for Diagnosing Mental Disorders in Primary Care: The PRIME-MD 1000 Study A1 - Spitzer, Robert L A1 - Williams, Janet B W A1 - Johnson, Jeffrey G A1 - Kroenke, Kurt A1 - Linzer, Mark A1 - Degruy, Frank Verloin A1 - Brody, David A1 - Hahn, Steven R Y1 - 1994/// JF - JAMA: The Journal of the American Medical Association VL - 272 IS - 22 SP - 1749 EP - 1756 DO - 10.1001/jama.1994.03520220043029 N2 - To assess the validity and utility of PRIME-MD (Primary Care Evaluation of Mental Disorders), a new rapid procedure for diagnosing mental disorders by primary care physicians. —Survey; criterion standard. —Four primary care clinics. —A total of 1000 adult patients (369 selected by convenience and 631 selected by site-specific methods to avoid sampling bias) assessed by 31 primary care physicians. —PRIME-MD diagnoses, independent diagnoses made by mental health professionals, functional status measures (Short-Form General Health Survey), disability days, health care utilization, and treatment/ referral decisions. —Twenty-six percent of the patients had a PRIME-MD diagnosis that met full criteria for a specific disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition. The average time required of the primary care physician to complete the PRIME-MD evaluation was 8.4 minutes. There was good agreement between PRIME-MD diagnoses and those of independent mental health professionals (for the diagnosis of any PRIME-MD disorder, κ=0.71; overall accuracy rate=88%). Patients with PRIME-MD diagnoses had lower functioning, more disability days, and higher rates of health care utilization than did patients without PRIME-MD diagnoses (for all measures, P<.005). Nearly half (48%) of 287 patients with a PRIME-MD diagnosis who were somewhat or fairly well-known to their physicians had not been recognized to have that diagnosis before the PRIME-MD evaluation. A new treatment or referral was initiated for 62% of the 125 patients with a PRIME-MD diagnosis who were not already being treated. —PRIME-MD appears to be a useful tool for identifying mental disorders in primary care practice and research. (JAMA. 1994;272:1749-1756). © 1994, Walter de Gruyter. All rights reserved. ER - TY - GEN T1 - Detección de depresión en adultos A1 - Williams, John A1 - Nieuwsma, Jason Y1 - 2019/// UR - https://www-uptodate-com.ez.urosario.edu.co/contents/screening-for-depression-in-adults?search=phq9§ionRank=1&usage_type=default&anchor=H278060398&source=machineLearning&selectedTitle=1~62&display_rank=1#H278060398 ER - TY - JOUR T1 - The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: A systematic review A1 - Kroenke, Kurt A1 - Spitzer, Robert L A1 - Williams, Janet B W A1 - Löwe, Bernd Y1 - 2010/// JF - General Hospital Psychiatry VL - 32 IS - 4 SP - 345 EP - 359 DO - 10.1016/j.genhosppsych.2010.03.006 N2 - Background: Depression, anxiety and somatization are the most common mental disorders in primary care as well as medical specialty populations; each is present in at least 5-10% of patients and frequently comorbid with one another. An efficient means for measuring and monitoring all three conditions would be desirable. Methods: Evidence regarding the psychometric and pragmatic characteristics of the Patient Health Questionnaire (PHQ)-9 depression, generalized anxiety disorder (GAD)-7 anxiety and PHQ-15 somatic symptom scales are synthesized from two sources: (1) four multisite cross-sectional studies (three conducted in primary care and one in obstetric-gynecology practices) comprising 9740 patients, and (2) key studies from the literature that have studied these scales. Results: The PHQ-9 and its abbreviated eight-item (PHQ-8) and two-item (PHQ-2) versions have good sensitivity and specificity for detecting depressive disorders. Likewise, the GAD-7 and its abbreviated two-item (GAD-2) version have good operating characteristics for detecting generalized anxiety, panic, social anxiety and post-traumatic stress disorder. The optimal cutpoint is ≥10 on the parent scales (PHQ-9 and GAD-7) and ≥3 on the ultra-brief versions (PHQ-2 and GAD-2). The PHQ-15 is equal or superior to other brief measures for assessing somatic symptoms and screening for somatoform disorders. Cutpoints of 5, 10 and 15 represent mild, moderate and severe symptom levels on all three scales. Sensitivity to change is well-established for the PHQ-9 and emerging albeit not yet definitive for the GAD-7 and PHQ-15. Conclusions: The PHQ-9, GAD-7 and PHQ-15 are brief well-validated measures for detecting and monitoring depression, anxiety and somatization. © 2010. ER - TY - JOUR T1 - Equations for converting scores between depression scales (MÅDRS, SRS, PHQ-9 and BDI-II): good statistical, but weak idiographic, validity A1 - Hawley, Chris A1 - Gale, Tim A1 - John Smith, Paul A1 - Jain, Sanjay A1 - Farag, Ako A1 - Kondan, Raj A1 - Avent, Cerian A1 - Graham, Juliet Y1 - 2013/// JF - Hum. Psychopharmacol Clin Exp VL - 28 SP - 544 EP - 551 DO - 10.1002/hup N2 - BACKGROUND: Although treatment of bipolar depression is a frequent clinical problem, double-blind studies of the treatment of bipolar depression are scarce. Some case series and uncontrolled data suggest antidepressants may differ in their propensity to induce mania or their efficacy for bipolar depression. METHOD: The authors conducted a prospective double-blind trial to assess efficacy and rate of treatment-emergent mood elevation in depressed bipolar patients when bupropion or desipramine was added to an ongoing therapeutic regimen of lithium or an anticonvulsant. Results were assessed after 8 weeks of acute treatment and during maintenance treatment up to 1 year. RESULTS: No difference was found for acute efficacy between the two drugs. Mania/hypomania was observed in 5 of 10 desipramine-treated patients, but only 1 of 9 bupropion-treated patients. The occurrence of hypomania or mania was correlated with treatment group (Kendall's tau correlation = 0.42; Z = -2.5, p < .012). CONCLUSION: These pilot findings suggest that bupropion is less likely to induce mood elevation than desipramine. For treatment of bipolar depression, bupropion and desipramine appear to have similar antidepressant efficacy. ER - TY - JOUR T1 - Comparing the beck depression inventory-II (BDI-II) and Patient Health Questionnaire (PHQ-9) depression measures in an integrated mood disorders practice A1 - Kung, Simon A1 - Alarcon, Renato D A1 - Williams, Mark D A1 - Poppe, Kathleen A A1 - Jo Moore, Mary A1 - Frye, Mark A Y1 - 2013/// JF - Journal of Affective Disorders VL - 145 IS - 3 SP - 341 EP - 343 DO - 10.1016/j.jad.2012.08.017 N2 - Background: Patient self-assessment instruments are useful in screening, tracking, and documenting the course of depressive symptoms with minimal clinician time. Two popular instruments are the Beck Depression Inventory (BDI-II) and the Patient Health Questionnaire (PHQ-9). We compared the performance of these two instruments in a mood disorders setting. Methods: A retrospective study of 625 patients who completed a PHQ-9 and BDI-II as part of routine clinical care (1) during initial outpatient evaluation between 2008 and 2009, and (2) on admission to an inpatient mood disorders unit between 2006 and 2009. Pearson correlation coefficients for total PHQ-9 and BDI-II scores were calculated for all patients, the outpatients, and the inpatients. Results: Overall r=0.77, indicating strong correlation, more in the outpatients (n=287, r=0.81) than the inpatients (n=338, r=0.67). Mean PHQ-9 and BDI-II scores for the outpatients were 15.1 (SD 7.4) and 27.8 (SD 14.1) corresponding to moderately severe and moderate categories respectively; for inpatients, 18.9 (SD 5.7) and 33.8 (SD 11.5) corresponding to moderately severe and severe. Limitations: Retrospective design and no monitoring of which instrument was completed first in case that influenced patient response to the second instrument Conclusions: PHQ-9 and BDI-II scores, as continuous but not categorical variables, in a mood disorders subspeciality setting are closely correlated and essentially interchangeable. There are practical applications to our findings, as the PHQ-9 is shorter and free. © 2012 Elsevier B.V. ER - TY - JOUR T1 - Using the Patient Health Questionnaire-9 to measure depression among racially and ethnically diverse primary care patients A1 - Huang, Frederick Y A1 - Chung, Henry A1 - Kroenke, Kurt A1 - Delucchi, Kevin L A1 - Spitzer, Robert L Y1 - 2006/// JF - Journal of General Internal Medicine VL - 21 IS - 6 SP - 547 EP - 552 DO - 10.1111/j.1525-1497.2006.00409.x N2 - OBJECTIVE: The Patient Health Questionnaire depression scale (PHQ-9) is a well-validated, Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) criterion-based measure for diagnosing depression, assessing severity and monitoring treatment response. The performance of most depression scales including the PHQ-9, however, has not been rigorously evaluated in different racial/ethnic populations. Therefore, we compared the factor structure of the PHQ-9 between different racial/ethnic groups as well as the rates of endorsement and differential item functioning (DIF) of the 9 items of the PHQ-9. The presence of DIF would indicate that responses to an individual item differ significantly between groups, controlling for the level of depression. MEASUREMENTS: A combined dataset from 2 separate studies of 5,053 primary care patients including non-Hispanic white (n=2,520), African American (n=598), Chinese American (n=941), and Latino (n=974) patients was used for our analysis. Exploratory principal components factor analysis was used to derive the factor structure of the PHQ-9 in each of the 4 racial/ethnic groups. A generalized Mantel-Haenszel statistic was used to test for DIF. RESULTS: One main factor that included all PHQ-9 items was found in each racial/ethnic group with α coefficients ranging from 0.79 to 0.89. Although endorsement rates of individual items were generally similar among the 4 groups, evidence of DIF was found for some items. CONCLUSIONS: Our analyses indicate that in African American, Chinese American, Latino, and non-Hispanic white patient groups the PHQ-9 measures a common concept of depression and can be effective for the detection and monitoring of depression in these diverse populations. ER - TY - JOUR T1 - Reliability and dimensionality of PHQ-9 in screening symptoms of depression among health science students in Cartagena, 2014 A1 - Cassiani-Miranda, Carlos Arturo A1 - Vargas-Hernández, María Camila A1 - Pérez-Anibal, Eduard A1 - Herazo-Bustos, Mariana Isabel A1 - Hernández-Carrillo, Mauricio Y1 - 2017/// JF - Biomédica VL - 37 IS - 1 SP - 112 EP - 120 DO - 10.7705/biomedica.v37i0.3221 N2 - Introducción. Es necesario el cribado de depresión en estudiantes universitarios con instrumentos válidos. El Cuestionario de Salud del Paciente (PHQ-9) es confiable y valido para tamizaje de depresión en el contexto universitario, pero su desempeño psicométrico en Colombia se desconoce.Objetivo. Estimar la confiabilidad y dimensionalidad del PHQ-9 como instrumento de tamizaje para sintomatología depresiva en estudiantes del área de ciencias de la salud de una universidad en Cartagena, Colombia.Materiales y métodos. Se estudió la estructura factorial y la confiabilidad del PHQ-9. La muestra fue de 550 estudiantes para una prevalencia esperada de síntomas depresivos con importancia clínica (SDIC) del 25%. Nivel de confianza del 95%, error de 3%. Se utilizó la versión en español de la escala PHQ-9 de uso libre para Colombia. Se realizó un análisis factorial confirmatorio, la estimación de la consistencia interna con Alfa de Cronbach y omega de McDonald.Resultados. Se analizaron 541 encuestas. La edad media del grupo fue de 20,18 (DE 2,59) años, 354 (63,77%) eran mujeres y 196 (36,23%) eran hombres. La prevalencia de SDIC fue del 27,3%. El análisis factorial confirmatorio mostró un modelo de dos factores, que explicaron el 42,80% de la varianza total. La proporción de la varianza explicada por los factores fue entre 0,243 (ítem 5) y 0,587 (ítem 2). El Alfa de Cronbach fue 0,830 y Omega de McDonald fue 0,89. Conclusiones. El PHQ-9 es una herramienta válida y confiable para el cribado de sintomatología depresiva en estudiantes de ciencias de la salud de una universidad en Cartagena-Colombia. ER - TY - BOOK T1 - Burnout - praxisnah A1 - Jaggi, Ferdinand ED - Gmbh, Lehmanns Media ED - Gmbh, Lehmanns Media Y1 - 2019/// CY - Berlin SN - 978-3-86541-939-2 ER - TY - JOUR T1 - Validación de Burnout screening inventory en personal de formación del área de la salud A1 - Dávila, Fabián A A1 - Nevado, Natalia Y1 - 2016/// JF - Educacion Medica VL - 17 IS - 4 SP - 158 EP - 163 DO - 10.1016/j.edumed.2016.08.007 N2 - Introduction Burnout syndrome involves a significant impact on working life. The Burnout screening inventory (BSI), has been developed for the diagnosis of burnout. A validation of the BSI in trainees in the area of health is presented. Materials and methods A computerised questionnaire was completed by volunteers belonging to areas of health education. They scored each item on a scale where 0 equalled «never» and 6 «every day». The overall score was obtained the sum of values. Descriptive statistics were performed on each item/overall, item/item and reliability, Cronbach's coefficient alpha. The differences between subgroups were also determined. They all assumed a statistical confidence level of 95%. Results A total of 73 people completed the study, of whom 71.2% were interns.; 1.4% had moderate burnout syndrome was observed in 1.4%. Good reliability coefficients were noted in all 3 domains (> 0.6), as well as overall (0.87). The item «My situation is desperate and have no way out. Sometimes I have the feeling of being on edge» had the highest overall correlation. Items 5 vs. 7, 5 vs. 8, and 8 vs. 9 were the highest correlation item/item (> 0.6). Items of the depersonalisation domain showed the highest mean values, with no significant differences between the domains by the type of training practice. Conclusions The BSI showed to be a reliable scale to measure burnout in healthcare trainees. Studies with before and after interventions in the workplace are required to determine sensitivity to change of this tool. ER - TY - JOUR T1 - Detecting Alcoholism The CAGE Questionnaire A1 - Ewing, John Y1 - 1984/// JF - JAMA VL - 252 IS - 14 DO - 10.1093/occmed/kqu058 N2 - Four clinical interview questions, the CAGE questions, have proved useful in helping to make a diagnosis of alcoholism. The questions focus on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers. The acronym "CAGE" helps the physician to recall the questions. How these questions were identified and their use in clinical and research studies are described. (JAMA 1984;252:1905-1907) THE DEVELOPMENT and clinical use of the CAGE questions were described in an original paper1 pre¬ sented at an International Conference on Alcoholism, but since the paper was not published outside of the pro¬ ceedings of the meeting it has not been readily available. Mayfield and colleagues2 brought the attention of the clinical alcohol¬ ism field to the existence of the CAGE questions when they published a validating study. Subsequently, the use of these questions in either clini¬ cal or experimental settings has been described in at least 17 publications, and the questionnaire has been alluded to in six other instances (ref¬ erence list available from author). In many such cases, the CAGE questions have been used and reported on with¬ out attribution to their originators. Acceptability ER - TY - JOUR T1 - Guía de Buenas Prácticas A1 - fare Y1 - 2013/// JF - Biblioteca de Cataluña SP - 25 EP - 25 ER - TY - JOUR T1 - The CAGE questionnaire A1 - Williams, Nerys Y1 - 2014/// JF - Occupational Medicine VL - 64 IS - 6 SP - 473 EP - 474 DO - 10.1093/occmed/kqu058 N2 - Four clinical interview questions, the CAGE questions, have proved useful in helping to make a diagnosis of alcoholism. The questions focus on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers. The acronym "CAGE" helps the physician to recall the questions. How these questions were identified and their use in clinical and research studies are described. (JAMA 1984;252:1905-1907) THE DEVELOPMENT and clinical use of the CAGE questions were described in an original paper1 pre¬ sented at an International Conference on Alcoholism, but since the paper was not published outside of the pro¬ ceedings of the meeting it has not been readily available. Mayfield and colleagues2 brought the attention of the clinical alcohol¬ ism field to the existence of the CAGE questions when they published a validating study. Subsequently, the use of these questions in either clini¬ cal or experimental settings has been described in at least 17 publications, and the questionnaire has been alluded to in six other instances (ref¬ erence list available from author). In many such cases, the CAGE questions have been used and reported on with¬ out attribution to their originators. Acceptability ER - TY - JOUR T1 - Alcohol Use Disorders: Screening and Diagnosis A1 - Maisto, Stephen A A1 - Saitz, Richard Y1 - 2003/// JF - The American Journal on Addictions VL - 12 SP - s12 EP - s25 DO - 10.1111/j.1521-0391.2003.tb00493.x N2 - The purpose of this article is to provide an overview of empirically supported, primarily self report methods of screening and diagnosis related to alcohol use disorders (AUDs). The discussion of screening instruments focuses on the primary care setting, and the diagnosis instruments. Discussion centers on the alcohol (and other drug) treatment setting. The literature shows that be AUDIT and CAGE are the most widely validated methods of screening for AUDs in primary care and may be applied readily in that context. Similarly, a number of instruments designed to derive DSM-IV (and ICD-10) AUD diagnoses, as well as constructs related to how AUDs are defined, are available and can meet a variety of clinical needs. Future research priorities include further development of brief methods to identify hazardous drinkers or individuals who have an AUD, as well as refinement of diagnosis instruments to increase their application across treatment settings and subpopulations. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract) ER - TY - JOUR T1 - Propiedades psicométricas del cuestionario CAGE para consumo abusivo de alcohol: resultados de tres análisis A1 - Campo-arias, Adalberto A1 - Barros-bermúdez, Jaider Alfonso A1 - Rueda-jaimes, Germán Eduardo Y1 - 2009/// JF - Revista Colombiana de Psiquiatría VL - 38 IS - 2 SP - 294 EP - 303 N2 - Introducción: El cuestionario CAGE es el instrumento más usado para identificar el consumo abusivo de alcohol; pero no se conocen muchas de sus propiedades psicométricas en los adultos colombianos. Objetivo: Determinar la consistencia interna del cuestionario CAGE en fumadores y no fumadores adultos que informaron consumo de alcohol durante el último mes y conocer el comportamiento psicométrico frente a una entrevista clínica estructurada en un grupo de adultos fumadores de la población general de Bucaramanga, Colombia. Método: Se diseñó un estudio de validación de una prueba diagnóstica en tres grupos de la población general. Se determinó la consistencia interna mediante la fórmula 20 de Kuder-Richardson y las propiedades frente a una entrevista clínica en un subgrupo de fumadores (sensibilidad, especificidad, valores predictivos, razones de probabilidad, kappa de Cohen y área bajo la curva ROC). Resultados: La consistencia interna estuvo entre 0,753 y 0,834. En fumadores, para el punto de corte de 2, la sensibilidad fue 66,7% (IC95%: 38,8-87,0); la especificidad, 86,0% (IC95%: 73,7-93,3); el valor predictivo positivo, 55,6% (IC95%: 31,3-77,6); el valor predictivo negativo, 90,7% (IC95%: 78,9-96,5); la razón de probabilidad positiva, 4,8; la razón de probabilidad negativa, 0,39; la kappa media de Cohen, 0,490 (IC95%: 0,253-0,727), y el área bajo la curva ROC, 0,805 (IC95%: 0,680-0,929). Conclusiones: El cuestionario CAGE muestra aceptable consistencia interna y modestas propiedades cuando se compara con una entrevista clínica en personas fumadoras. Palabras clave: tabaquismo, adulto, estudios de validación. Abstract Introduction: The CAGE questionnaire is the scale most commonly used to identify abusive use of alcohol; however, many of its psychometric properties in the Colombian adult population ER - TY - JOUR T1 - The drug abuse screening harvey a. skinner test A1 - Skinner, Harvey A Y1 - 1982/// JF - International Journal VL - 7 SP - 363 EP - 371 ER - TY - BOOK T1 - Validity of the Drug Abuse Screening Test (DAST-10) in inpatient substance abusers A1 - Bohn, M J A1 - Babor, T F A1 - Kranzler, H R Y1 - 1992/// JF - Problems of Drug Dependence SN - 0160361605 N2 - See page 131 for Glennon Serotonin affinity for 5-HT2 and other agonists relating to hallucinations ER - TY - JOUR T1 - A comprehensive review of the psychometric properties of the Drug Abuse Screening Test A1 - Yudko, Errol A1 - Lozhkina, Olga A1 - Fouts, Adriana Y1 - 2007/// JF - Journal of Substance Abuse Treatment VL - 32 IS - 2 SP - 189 EP - 198 DO - 10.1016/j.jsat.2006.08.002 N2 - This article reviews the reliability and the validity of the (10-, 20-, and 28-item) Drug Abuse Screening Test (DAST). The reliability and the validity of the adolescent version of the DAST are also reviewed. An extensive literature review was conducted using the Medline and Psychinfo databases from the years 1982 to 2005. All articles that addressed the reliability and the validity of the DAST were examined. Publications in which the DAST was used as a screening tool but had no data on its psychometric properties were not included. Descriptive information about each version of the test, as well as discussion of the empirical literature that has explored measures of the reliability and the validity of the DAST, has been included. The DAST tended to have moderate to high levels of test-retest, interitem, and item-total reliabilities. The DAST also tended to have moderate to high levels of validity, sensitivity, and specificity. In general, all versions of the DAST yield satisfactory measures of reliability and validity for use as clinical or research tools. Furthermore, these tests are easy to administer and have been used in a variety of populations. © 2007 Elsevier Inc. All rights reserved. ER - TY - JOUR T1 - Validación española del Drug Abuse Screening Test (DAST-20 y DAST-10) A1 - Pérez, B A1 - García, L A1 - de Vicente, M P A1 - Oliveras, M A A1 - Lahoz, M Y1 - 2010/// JF - Health and addictions: salud y drogas VL - 10 IS - 1 SP - 35 EP - 50 ER - TY - JOUR T1 - Estrategia de orientación y asesoría a jóvenes con consumos iniciales de drogas. Un modelo basado en evidencia para el Distrito Capital A1 - D.C., Alcaldía Mayor de Bogotá A1 - Delito, UNODC - Oficina de las Naciones Unidas contra la Droga y el Y1 - 2013/// ER - TY - JOUR T1 - Hallazgos Psicométricos De La Escala Para Ideación Suicida Del Centro De Estudios Epidemiológicos En Adolescentes Escolarizados De Samacá, Boyacá, Colombia A1 - Pineda-Roa, Carlos Alejandro A1 - Martínez-Chía, Ángela Paola A1 - Corredor-González, Diana Yuranny A1 - Herazo, Edwin A1 - Campo-Arias, Adalberto Y1 - 2018/// JF - Biosalud VL - 17 IS - 2 SP - 47 EP - 55 DO - 10.17151/biosa.2018.17.2.4 ER - TY - JOUR T1 - Depressive Symptoms and Suicidal Ideation among Mexican-Origin and Anglo Adolescents A1 - Roberts, Robert E A1 - Chen, Yuan Who Y1 - 1995/// JF - Journal of the American Academy of Child and Adolescent Psychiatry VL - 34 IS - 1 SP - 81 EP - 90 DO - 10.1097/00004583-199501000-00018 N2 - To examine the prevalence of depressive symptoms and suicidal ideation, their comorbidity, and associated risk factors in adolescence. A self-administered questionnaire was completed in class by students in three middle schools (grades 6 through 8) enrolling more than 3,200 students. Usable questionnaires were obtained from 2,614 (81.5%), of which 924 were Anglo and 1,354 were of Mexican origin. Depression was measured using the 20-item Center for Epidemiologic Studies Depression Scale and suicidal ideation using four items on thoughts of death and suicide. The minority adolescents reported significantly higher crude prevalence rates of symptoms of depression and thoughts of suicide than their Anglo counterparts. Prevalence rates were highest for females of Mexican origin. There was a strong association between depression and suicidal ideation in both ethnic groups. Multivariate logistic regression analyses indicated significant correlates of depressive symptoms were suicidal ideation (adjusted odds ratio = 10.9), loneliness, and use of English, in that order. Significant correlates of suicidal ideation were depression (adjusted odds ratio = 10.6), loneliness, two-parent household, use of English, and being of Mexican origin. More than 80% of those with high ratings on suicidal ideation scored as depressed in both ethnic groups. Results are consistent with other studies suggesting rates of suicidal ideation among adolescents are in the 10% to 20% range, while rates of depressive symptoms are in the 35% to 50% range using standard caseness scores. Mexican-American youths appear to be at higher risk than Anglo youths, particularly for suicidal ideation. In addition, it appears that youths who are lonely are more likely to report higher rates of both depression and suicidal ideation. The data also indicate that youths who spoke only or mostly English reported lower rates of depression and suicidal ideation, suggesting that acculturation may play a role as well. © 1995, The American Academy of Child and Adolescent Psychiatry. All rights reserved. ER - TY - JOUR T1 - Ideación Suicida en Adolescentes: Un Análisis Psicosocial A1 - Sánchez-Sosa, Juan Carlos A1 - Villarreal-González, María Elena A1 - Musitu, Gonzalo A1 - Martinez Ferrer, Belen Y1 - 2010/// JF - Psychosocial Intervention VL - 19 IS - 3 SP - 279 EP - 287 DO - 10.5093/in2010v19n3a8 N2 - Se especificó y contrastó un modelo explicativo psicosocial de ideación suicida en adolescentes, mediante un estudio explicativo de tipo transversal. Se utilizó una muestra probabilística estratificada de 1285 estudiantes mexicanos de escolaridad media y media superior. Los instrumentos utilizados tenían índices adecuados de fiabilidad. Se contrastó el modelo con la técnica de ecuaciones estructurales utilizan- do el paquete estadístico EQS 6.1 que explicó el 33.10 % de varianza explicada. Los resultados mostraron que el modelo obtuvo niveles adecuados de bondad de ajuste absoluto (RMSEA=.41; GFI=.953; AGFI=.939) y comparativo (CFI=.951; IFI=.958; NFI=.925; NNFI=.943). Se concluyó que el Modelo Explicativo Psicosocial de Ideación Suicida (MEPIS) se ajustaba bien a los datos y era compatible con el modelo teórico propuesto, al integrar una estructura contextual que presentaba una relación indirecta y sig- nificativa del funcionamiento familiar y los problemas de integración escolar con la variable dependiente. Además, también se observó, una relación directa y significativa de la victimización escolar, sintomatología depresiva y conducta alimentaria de riesgo con la ideación suicida. Palabras clave: adolescencia, escuela, factores psicosociales, familia, ideación suicida. ER - TY - JOUR T1 - Confiabilidad y validez de la escala de ideación suicida de roberts A1 - Rosales-Pérez, José Carlos A1 - Córdova-Osnaya, Martha A1 - Cortés-Granados, Ricardo Y1 - 2015/// JF - Journal of Behavior, Health & Social Issues VL - 7 IS - 2 SP - 31 EP - 41 DO - 10.5460/jbhsi.v7.2.44302 N2 - Se presenta una investigación cuyos objetivos fueron revisar la confiabilidad y validez de la Escala de Idea- ción Suicida de Roberts y el punto de corte conveniente para registrar la presencia de ideación suicida. Método: A una muestra no aleatoria de 200 hombres (42%) y 276 mujeres (58%), estudiantes del ciclo es- colar 2012-2 del Colegio de Ciencias y Humanidades plantel Vallejo, se les aplicó la batería de instrumentos para la Evaluación de Ideación Suicida en Jóvenes, integrado por tres secciones; identificación personal, constructos psicológicos e ideación suicida. Se registró la confiabilidad, la validez factorial, convergente y predictiva de la Escala de Ideación Suicida. Se identificó el punto de corte adecuado de la escala por medio del registro de sensibilidad y especificidad. Resultados: Confiabilidad de .76, validez factorial con agrupa- ción de reactivos en un factor, varianza explicada total del 63.4 %; porcentajes adecuados de pronóstico al grupo de pertenencia; 70 % al 90 %. Correlación positiva con variables psicológicas y de identificación personal asociadas generalmente a la presencia de ideación suicida. Identificación de punto de corte co- rrespondiente a + 5 DE. Conclusiones: La Escala de Ideación Suicida de Roberts es una opción adecuada para el registro de la presencia de ideación suicida, pero se requiere corroborar los resultados encontrados en investigaciones posteriores. ER - TY - JOUR T1 - Características Del Estudiante Con Y Sin Ideación Suicida Del Colegio De Bachilleres De San Luis Potosí ( México ) A1 - Cordova, Martha A1 - Rosales, Jose Carlos A1 - Guzman, Brisa A1 - Zùñiga, Gregorio Y1 - 2013/// JF - SALUD & SOCIEDAD VL - 4 IS - 2 SP - 120 EP - 134 ER - TY - JOUR T1 - Prevalencia de la ideación suicida en estudiantes de Medicina en Latinoamérica: un meta análisis / Prevalence of Suicidal Ideation in Medical Students of Latin America: a Meta-analysis A1 - Denis-Rodríguez, Edmundo A1 - Barradas Alarcón, María Esther A1 - Delgadillo-Castillo, Rodolfo A1 - Denis-Rodríguez, Patricia Beatríz A1 - Melo-Santiesteban, Guadalupe Y1 - 2017/// JF - RIDE Revista Iberoamericana para la Investigación y el Desarrollo Educativo VL - 8 IS - 15 SP - 387 EP - 418 DO - 10.23913/ride.v8i15.304 N2 - Hablar de conductas suicidas es hablar de diferentes etapas o fases que la persona puede llegar a presentar; generalmente inicia con un pensamiento suicida, después una planeación del suicidio y, finalmente, la búsqueda de los recursos para llegar al suicidio. Es importante señalar que la secuencia de estas fases no es una regla general; sin embargo, cada una de ellas pone en riesgo a la persona. El objetivo es realizar una revisión de los pasos que se han dado para constituir en objeto de investigación la ideación suicida y el suicido consumado en estudiantes de medicina. Es una investigación documental de tipo meta-análisis. El meta análisis es una integración estructurada y sistemática de la información obtenida en diferentes estudios, en este caso sobre la ideación suicida y el suicidio. Este tipo de revisión da una estimación cuantitativa y sintética de todos los estudios disponibles. En esta revisión se destacan los instrumentos utilizados para medir esta problemática, como son: el Inventario de Depresión de Beck, Inventario de Orientaciones Suicidas de Casullo, la Escala de Personalidad de Catell, el Cuestionario Multimodal de Interacción Escolar, escala de Zung, entre otros. El suicidio es un problema de salud pública, responsable de más de 800 000 defunciones anuales en todo el mundo y es la segunda causa de muerte en individuos entre los 15 y 29 años de edad; este fenómeno ha comenzado a ser estudiado en Latinoamérica en fecha reciente. A partir de lo observado en este meta-análisis, basado en estudios incluidos en los buscadores Medline, Cochrane y Scielo, la prevalencia media de ideación suicida en Latinoamérica es 13.85 %, ligeramente por debajo de lo observado en Europa y Estados Unidos. La prevalencia media observada en México es 8.76 % aunque este valor es poco confiable dado que es producto de 3 estudios en los que la metodología usada fue distinta y en dos de ellos se incluyeron residentes médicos en vez de estudiantes de pregrado. En conclusión, deben realizarse estudios metodológicamente bien planeados para valorar la ideación suicida en estudiantes de medicina, analizando variables como el sexo, el año escolar, el abuso de sustancias tóxicas, psicopatologías asociadas y otras características sociodemográficas que nos permitan explicar la razón por la que la ideación suicida pudiera ser más elevada en estudiantes de medicina, hecho que sugieren diversos estudios realizados en el mundo en poblaciones heterogéneas. ER - TY - JOUR T1 - Impairment Prevention in the Training Years A1 - Borenstein, Daniel Y1 - 1982/// JF - JAMA VL - 247 IS - 19 ER - TY - JOUR T1 - Medical student mental health services: Psychiatrists treating medical students A1 - Gentile, Julie P A1 - Roman, Brenda Y1 - 2009/// JF - Psychiatry VL - 6 IS - 5 SP - 38 EP - 45 N2 - Medical school is a stressful and challenging time in the academic career of physicians. Because of the psychological pressure inherent to this process, all medical schools should have easily accessible medical student mental health services. Some schools of medicine provide these services through departments of psychiatry or other associated training programs. Since this stressful lifestyle often continues through residency training and life as a physician, this is a critical period in which to develop and utilize functional and effective coping strategies. When psychiatrists provide the mental health treatment to medical students, it is important to consider transference and countertransference issues, over intellectualization, and instances of strong idealization and identification. ER - TY - JOUR T1 - Mental health services for residents: More important than ever A1 - Pitt, Elaine A1 - Rosenthal, Marilynn M A1 - Gay, Tamara L A1 - Lewton, Elizabeth Y1 - 2004/// JF - Academic Medicine VL - 79 IS - 9 SP - 840 EP - 844 DO - 10.1097/00001888-200409000-00005 N2 - The mental health of physicians in training is a topic of considerable concern. Recent attention to the issue of patient safety has led to examination of the relationship between residents' stress and compromised clinical performance. Few mental health programs dedicated to residents and formally structured to meet their specific needs are reported in the literature. The authors raise the question of why there are so few programs and why more residents don't take advantage of services that do exist. They then describe the development and utilization of the University of Michigan Health System's House Officer Mental Health Program. The program was structured to overcome barriers to utilization such as lack of funding, concerns about confidentiality, ease of access and residents' financial constraints and to provide comprehensive services for a wide range of diagnoses. Data are presented on the first four years of operation from 1997-01 that show increasing utilization and high levels of satisfaction over this time period by house officers at all levels of training and in all departments of the Health System. As increasing attention is paid to how to deal with medical errors, the establishment of such programs should be considered, not only as a means to address the general mental health of residents but also as an appropriate venue to deal with the stress that can contribute to and be induced by medical mishaps. ER - TY - JOUR T1 - A Review on Strategies to Manage Physician Burnout A1 - Patel, Rikinkumar S A1 - Sekhri, Shiana A1 - Bhimanadham, Narmada N A1 - Imran, Sundus A1 - Hossain, Sadaf Y1 - 2019/// JF - Cureus VL - 11 IS - 6 SP - 3 EP - 12 DO - 10.7759/cureus.4805 N2 - Physician burnout is an emerging condition that can adversely affect the performance of modern-day medicine. Its three domains are emotional exhaustion, depersonalization, and a sense of reduced accomplishment among physicians, with the Maslach Burnout Inventory (MBI) being the gold standard questionnaire used to scale physician burnout. This concern not only impacts physicians but the entire healthcare system in general. There is growing awareness regarding the mental health of physicians and the consequences faced by the healthcare system as a result of burnout. According to a recent study, more than 50% of physicians reported suffering from at least one burnout symptom. In this review article, we aim to identify the causes leading to burnout, its impact on physicians, and hospital management as well as interventions to reduce this work-related syndrome. Some contributing factors leading to burnout are poor working conditions with long work shifts, stressful on-call duties, lack of appreciation, and poor social interactions. Burnout can lead to adverse consequences, such as depression, substance use, and suicidal ideation in physicians and residents. This can result in poor patient care increasing total length of stay, re-admissions, and major medical errors. Due to increased scrutiny of patient and healthcare costs, along with increased lawsuits as a result of major medical errors, it is crucial for both the hospital management and physicians to recognize and address burnout among physicians. Comprehensive professional training such as Cognitive behavioral therapy (CBT), stress-reducing activities such as mindfulness and group activities, and strict implementation of work-hour limitations recommended by Accreditation Council for Graduate Medical Education (ACGME) for residents are a few methods that may help to manage burnout and increase productivity in hospitals. ER - TY - JOUR T1 - Efectos De La Pandemia Por Covid – 19 En La Salud Mental De Trabajadores Sanitarios Del Estado Mérida , Venezuela . A1 - Martínez, Fabiola A1 - Azkoul, Mejer A1 - Rangel, Catherine A1 - Sandia, Ignacio A1 - Pinto, Stefany Y1 - 2020/// JF - Revista GICOS VL - 5 IS - 2 SP - 77 EP - 88 N2 - The pandemic caused by SARS-CoV-2 has not only affected the physical health of millions of people, but also affects the mental health of the population, especially front-line health personnel. However, there is a large information gap in this regard, which is why it was proposed to evaluate the effects of the COVID-19 pandemic on the mental health of health personnel in the state of Mérida, Venezuela. Method: This is a descriptive and cross-sectional observational study, where the DASS-21 scale was applied to 150 individuals belonging to the health personnel of Mérida State, Venezuela. Results: Among those surveyed, 34.7% presented stress, 33.3% anxiety and 34.6% showed signs of depression, at different levels. It was determined that 42.7% of all participants were working in areas intended for care of COVID-19 patients, and those who have the positions of resident doctors and nurses, presented notable increases in the levels of the emotional variables studied. Conclusion: As a consequence of the pandemic, the demands for the medical practice increased, resulting in higher rates of stress, anxiety and depression in the health personnel who are responsible for dealing with it. For this reason, the importance of approaching these individuals in order to evaluate the status of mental health should be emphasized, and, if it is necessary, provide adequate therapy from the hand of psychiatrists and psychologists to ensure the integrity of those who represent the first line of defense against this new disease. ER - TY - JOUR T1 - Impacto de la epidemia del Coronavirus (COVID-19) en la salud mental del personal de salud y en la población general de China A1 - Lozano-Vargas, Antonio A1 - Lozano-Vargas, Antonio Y1 - 2020/// JF - Revista de Neuro-Psiquiatría VL - 83 IS - 1 SP - 51 EP - 56 DO - 10.20453/RNP.V83I1.3687 N2 - En la lucha contra la epidemia del Coronavirus (COVID-19), el personal de salud puede experimentar problemas de salud mental tales como estrés, ansiedad, síntomas depresivos, insomnio, negación, ira y temor. En un estudio en China se observó que la tasa de ansiedad del personal de salud fue del 23,04%, mayor en mujeres que en hombres y mayor entre las enfermeras que entre los médicos. Asimismo, en la población general de China se observó un 53,8% de impacto psicológico moderado a severo; un 16,5% de síntomas depresivos, un 28,8% de síntomas ansiosos y un 8,1% de estrés, todos entre moderados y severos. Los factores asociados con un alto impacto psicológico y niveles elevados de estrés, síntomas de ansiedad y depresión fueron sexo femenino, ser estudiante, tener síntomas físicos específicos y una percepción pobre de la propia salud. Otro estudio en el mismo país detectó un 35% de distrés psicológico en la población general, con las mujeres presentando mayores niveles que los varones, al igual que los sub-grupos de 18-30 años y los mayores de 60 años. La pandemia plantea pues el desafío de cuidar la salud mental del personal de salud tanto como la de la población general. Así, el uso de instrumentos breves de detección de problemas de salud mental, validados en nuestra población, sería de mucha utilidad para los retos de salud pública que afronta el país. ER - TY - JOUR T1 - Mental health risks and damage in healthcare personnel due to treating patients with COVID-19 Riesgos y daños en la salud mental del personal sanitario por la atención a pacientes con COVID-19 Correspondencia A1 - Torres-Muñoz, Víctor A1 - Diego Farias-Cortés, Juan A1 - Antonio Reyes-Vallejo, Luis A1 - Guillén-Díaz-Barriga, Centli A1 - Torres Muñoz Av Zoquipan, Víctor Y1 - 2020/// JF - Mex. Urol VL - 80 IS - 3 SP - 1 EP - 9 N2 - Description: A bibliographic review was conducted regarding the mental health impact on healthcare personnel resulting from hospital conditions, risk factors, and ethical/moral dilemmas caused by treating patients during the COVID-19 pandemic. Relevance: To prevent and detect mental health risks and damage in healthcare personnel by identifying the variables that increase the emotional burden from treating patients with COVID-19. Conclusions: Healthcare personnel can experience intense anxiety, uncertainty, loss of routines and traditions, stress, compassion fatigue, and moral distress, making them prone to the triggering of mental disorders , such as depression, post-traumatic stress disorder, and even suicidal ideation. Detecting behavior that is indicative of mental health disorders is a priority for mitigating their effects and implementing high quality support strategies that promote posttraumatic growth. Once the pandemic subsides, short-term, medium-term, and long-term monitoring of healthcare personnel is recommendable to identify and adequately treat the moral suffering or the resulting mental disorders, helping them recover their previously natural confidence in treating their patients. Keywords: Mental health, health personnel, COVID-19/ mental health, healthcare personnel, COVID-19. Citación: Torre-Muñoz V., Farias-Cortés J.D., Reyes-Vallejo L.A., Guillen-Díaz-Barriga C. Ries-gos y daños en la salud mental del personal sanitario por la atención a pacientes con Covid-19. Rev. ER - TY - THES T1 - UNIVERSIDAD AUTONOMA DE GRADO DE AFECTACIÓN DE LA SALUD MENTAL EN MÉDICOS RESIDENTES DE ANESTESIOLOGÍA DURANTE LA PANDEMIA SARS-COV-2 (COVID-19) A1 - ROIZ HERNÁNDEZ, humberto de jesus Y1 - 2021/// ER - TY - JOUR T1 - Estrés laboral y burnout en los médicos residentes, antes y durante la pandemia por COVID-19: una puesta al día A1 - Navinés, Ricard A1 - Olivé, Victoria A1 - Fonseca, Francina A1 - Martín-Santos, Rocío Y1 - 2021/// JF - Medicina Clinica VL - 157 IS - 3 SP - 130 EP - 130 DO - 10.1016/J.MEDCLI.2021.04.003 N2 - Introducción En los últimos a ˜ nos existe un amplio debate a nivel nacional e internacional sobre si los a ˜ nos de residencia constituyen un riesgo para la salud mental del médico residente 1. El periodo de formación de la especialidad conlleva un nivel de activación general y afronta-miento a nuevas situaciones que para la mayoría de los residentes es estimulante y provechoso. Sin embargo, para otros puede supo-ner un incremento de la respuesta al estrés del organismo, que al prolongarse en el tiempo e intensidad no permita la adecuada adap-tación y desemboque en un cuadro de agotamiento psicobiológico o burnout 2. Estrés es un término utilizado para denominar al estado de activación biológica antihomeostática que se produce cuando el organismo fracasa en sus intentos de adaptarse a las demandas de su entorno inmediato 3. Esta activación biológica se acompã na de emociones desagradables (ansiedad, tristeza, irritación) y de modificaciones fisiológicas de los subsistemas adaptativos (acti-vación autonómica y neuroendocrina e inhibición inmunitaria y conductual) que disminuyen las capacidades para mantener la homeostasis ante la interacción con el medio. Por ello, el estrés es un estado biológico complejo que resulta del procesamiento cerebral * Autor para correspondencia. Correo electrónico: rmsantos@clinic.cat (R. Martín-Santos). de la interacción del sujeto con el entorno 3 , que es propio de cada persona y que dependerá además del estímulo amenazador (p. ej., más intenso en las amenazas sociales que en las físicas) 3. El estrés incontrolable es un estado biológico de transición a la enfermedad 3 y puede precipitar diversas enfermedades cardiovasculares, diges-tivas, musculoesqueléticas, además de trastornos mentales como la ansiedad y la depresión 3,4. Se puede definir estrés laboral como la respuesta que se produce cuando las demandas y las presiones laborales no se corresponden con los conocimientos y habilidades del trabajador, y sobrepasan su capacidad para hacerles frente 2. Todos los trabajadores experimen-tan presión en el trabajo, pero es a medida que el sujeto percibe que las demandas rebasan sus recursos para afrontarlas cuando puede sobrevenir estrés laboral y riesgo de burnout 2. Por otro lado, según el modelo de esfuerzo-recompensa en el trabajo 3 , el riesgo de pre-sentar estrés y trastornos psicosomáticos se produciría cuando el esfuerzo no está compensado por factores de recompensa, como el salario, la estima, la promoción profesion… ER - TY - JOUR T1 - Factors Associated with Burnout Among Physicians: An Evaluation During a Period of COVID-19 Pandemic A1 - Dinibutun, Sait Revda Y1 - 2020/// JF - Journal of Healthcare Leadership VL - 12 SP - 85 EP - 85 DO - 10.2147/JHL.S270440 N2 - Purpose: The aim of the study is to evaluate the prevalence and extent of burnout among physicians and investigate the factors related with burnout and the influence of the fight against coronavirus (COVID-19) on the burnout syndrome. Methods: A cross-sectional survey design was adopted and conducted on 200 actively working physicians in Izmir/Turkey. Personal Information Form and Maslach Burnout Inventory were used in the survey. Results: The findings showed that the emotional exhaustion level of the physicians was medium, the levels of depersonalization and personal accomplishment were low, and the level of total burnout was low. It was observed that the burnout levels of males and females, and married and single physicians were similar. The emotional exhaustion level of 18–23-year-old physicians was lower than the rest of the physicians. Physicians’ level of satisfaction with their income is not effective on burnout. The burnout level of physicians who did not choose their profession willingly was determined to be higher than the burnout level of the physicians who chose their profession willingly. One important finding showed that the burnout level of physicians who actively involved in the fight against COVID-19 was lower than the burnout level of the physicians who did not actively involve in the fight against COVID-19. Conclusion: Although the impact of some demographic variables, such as gender, marital status and satisfaction of income on burnout, was similar among the groups, total burnout level was lower in physicians who actively fought with the virus. This result may suggest that those physicians who were actively involved in the fight against COVID-19 had a high sense of meaningfulness of work which will result in high satisfaction with the work itself and, thus, creating less burnout. Also, they had a stronger feeling of personal accomplishment as they faced the immediate outcomes of their care for people infected by COVID-19. ER - TY - JOUR T1 - A Comparison of Burnout Frequency Among Oncology Physicians and Nurses Working on the Frontline and Usual Wards During the COVID-19 Epidemic in Wuhan, China A1 - Y, Wu A1 - J, Wang A1 - C, Luo A1 - S, Hu A1 - X, Lin A1 - AE, Anderson A1 - E, Bruera A1 - X, Yang A1 - S, Wei A1 - Y, Qian Y1 - 2020/// JF - Journal of pain and symptom management VL - 60 IS - 1 SP - e60 EP - e65 DO - 10.1016/J.JPAINSYMMAN.2020.04.008 N2 - Context: The epidemic of coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China and has now spread worldwide. In the affected countries, physicians and nurses are under heavy workload conditions and are at high risk of infection. Objectives: The aim of this study was to compare the frequency of burnout between physicians and nurses on the frontline (FL) wards and those working in usual wards (UWs). Methods: A survey with a total of 49 questions was administered to 220 medical staff members from the COVID-19 FL and UWs, with a ratio of 1:1. General information, such as age, gender, marriage status, and the Maslach Burnout Inventory—medical personnel, were gathered and compared. Results: The group working on the FLs had a lower frequency of burnout (13% vs. 39%; P < 0.0001) and were less worried about being infected compared with the UW group. Conclusion: Compared with medical staff working on their UWs for uninfected patients, medical staff working on the COVID-19 FL ward had a lower frequency of burnout. These results suggest that in the face of the COVID-19 crisis, both FL ward and UW staff should be considered when policies and procedures to support the well-being of health care workers are devised. ER - TY - JOUR T1 - Ideación suicida, ansiedad, capital social y calidad de sueño en colombianos durante el primer mes de aislamiento físico por COVID-19 A1 - Rodriguez, Ubaldo Enrique A1 - León Valle, Zumeina Lucía A1 - Ceballos Ospino, Guillermo Augusto Y1 - 2020/// JF - Psicogente VL - 24 IS - 45 SP - 1 EP - 20 DO - 10.17081/psico.24.45.4075 N2 - Objetivo: explorar los niveles de ideación suicida, ansiedad, capital social y calidad de sueño en hombres y mujeres, según edades, en población colombiana durante el primer mes de Aislamiento Físico por pandemia de Covid-19. Método: Estudio exploratorio y en línea, con 484 sujetos. Se utilizaron cuatro Escalas: Escala de Okasha para Suicidalidad (Okasha-IS), ZungSelf-Rating Anxiety Scale-15 (SAS-15), The Personal Social Capital Scale (PSCS) y Pittsburgh Sleep Quality Index (PSQI). Los instrumentos se registraron en la Web y se suministró mediante WhatsApp, Facebook y E-mail. Resultados: Se encontró un índice de ideación suicida del 40% entre leve a severa. 97% de ansiedad leve a severa. Capital social personal regular (81%) y 23% con poca calidad de sueño. La edad se asoció de manera inversa con valores de IS, SAS y PSQI (p<0,01) y de manera directa con PSCS (p<0,05). Sexo se correlacionó positivamente con SAS-15 (p<0,01) y PQSI (p<0,05). Mediante Análisis de Varianza se encontró diferencia significativa en hombres en los valores del IS y PQSI (p<0,01) y en mujeres hay diferencia significativa en los valores de IS, SAS-15 y PQSI (p<0,01) en diferentes grupos de edades. Conclusiones: Las mujeres son más propensas a sentir ansiedad e ideación suicida asociados con Aislamiento Físico y bajo capital social, lo que puede desencadenar problemas psicológicos mayores. Los jóvenes menores de 20 años siguen siendo un grupo de mayor riesgo a padecer psicopatologías profundas, desencadenando suicidios. El presente estudio se adhiere a la idea de usar el término de distanciamiento Físico y no Aislamiento Social, dado que las relaciones sociales se mantienen desde niveles diferentes al contacto físico. ER - TY - JOUR T1 - COVID-19 y consumo de sustancias: revisión narrativa de la evidencia disponible. A1 - Arancibia, Marcelo A1 - Rojo, Alejandra A1 - Arancibia, Marcelo A1 - Rojo, Alejandra Y1 - 2021/// JF - Revista chilena de neuro-psiquiatría VL - 59 IS - 2 SP - 142 EP - 151 DO - 10.4067/S0717-92272021000200142 N2 - The coronavirus pandemic, the etiologic agent of coronavirus disease 2019 (COVID-19), has had sanitary, socioeconomic and psychosocial consequences associated to greater levels of anxiety, stress and emotional alterations on general population. An increase in substance consumption in the general population is presumed, as well as problematic consumption. In this line, people with substance use disorder constitute a more vulnerable population to the impact of the pandemic, especially in lockdown. We conducted a systematic search in the main databases about the impact of COVID-19 pandemic on substance consumption, performing a narrative synthesis of the available evidence based on the main substances addressed by the publications. We discuss the trends of alcohol, tobacco, opioids and cannabis consumption, and the recommendations regarding follow-up and therapeutic support. Mostly, the level of the evidence of the articles included is low, since they correspond to expert opinions and exploratory observational studies. Most of the conclusions derive from the extrapolation of data obtained during infectious outbreaks of previous forms of coronavirus. We suggest conducting primary studies on substance consumption and maintaining the clinical surveillance of people with substance use disorders in the post-pandemic period. ER - TY - CHAP T1 - Chapter 6, The stigma of addiction in the medical community BT - The stigma of addiction: an essential guide. A1 - Avery, J D A1 - Avery, J J Y1 - 2019/// JF - The stigma of addiction: an essential guide. CY - New York (NY) DO - 10.1007/978-3-030-02580-9 ER - TY - JOUR T1 - Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions A1 - Hasin, Deborah S A1 - Stinson, Frederick S A1 - Ogburn, Elizabeth A1 - Grant, Bridget F Y1 - 2007/// JF - Archives of general psychiatry VL - 64 IS - 7 SP - 830 EP - 842 DO - 10.1001/ARCHPSYC.64.7.830 N2 - Context: Epidemiologic information is important to inform etiological research and service delivery planning. However, current information on the epidemiology of alcohol use disorders in the United States is lacking. Objectives: To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, and treatment of DSM-IV alcohol abuse and dependence. Design, Setting, and Participants: Face-to-face interviews with a representative US adult sample (N = 43 093). Main Outcome Measures: Lifetime and 12-month DSM-IV alcohol abuse and dependence. Results: Prevalence of lifetime and 12-month alcohol abuse was 17.8% and 4.7%; prevalence of lifetime and 12-month alcohol dependence was 12.5% and 3.8%. Alcohol dependence was significantly more prevalent among men, whites, Native Americans, younger and unmarried adults, and those with lower incomes. Current alcohol abuse was more prevalent among men, whites, and younger and unmarried individuals while lifetime rates were highest among middle-aged Americans. Significant disability was particularly associated with alcohol dependence. Only 24.1% of those with alcohol dependence were ever treated, slightly less than the treatment rate found 10 years earlier. Strong associations between other substance use disorders and alcohol use disorders (odds ratios, 2.0-18.7) were lower but remained strong and significant (odds ratios, 1.8-7.5) when controlling for other comorbidity. Significant associations between mood, anxiety, and personality disorders and alcohol dependence (odds ratios, 2.1-4.8) were reduced in number and magnitude (odds ratios, 1.5-2.0) when controlling for other comorbidity. Conclusions: Alcohol abuse and dependence remain highly prevalent and disabling. Comorbidity of alcohol dependence with other substance disorders appears due in part to unique factors underlying etiology for each pair of disorders studied while comorbidity of alcohol dependence with mood, anxiety, and personality disorders appears more attributable to factors shared among these other disorders. Persistent low treatment rates given the availability of effective treatments indicate the need for vigorous education efforts for the public and professionals. ©2007 American Medical Association. All rights reserved. ER - TY - JOUR T1 - Mental Illness and Stigma in Surgical Residencies—An Unspoken Truth A1 - Fu, Whitney W A1 - Gauger, Paul G A1 - Newman, Erika A Y1 - 2021/// JF - JAMA Surgery VL - 156 IS - 2 SP - 117 EP - 118 DO - 10.1001/JAMASURG.2020.2965 ER - TY - JOUR T1 - Mental health consequences of the COVID-19 pandemic associated with social isolation A1 - Ramírez-Ortiz, Jairo A1 - Castro-Quintero, Diego A1 - Lerma-Córdoba, Carmen A1 - Yela-Ceballos, Francisco A1 - Escobar-Córdoba, Franklin A1 - Ramírez-Ortiz, Jairo A1 - Castro-Quintero, Diego A1 - Lerma-Córdoba, Carmen A1 - Yela-Ceballos, Francisco A1 - Escobar-Córdoba, Franklin Y1 - 2020/// JF - Colombian Journal of Anestesiology VL - 48 IS - 4 DO - 10.5554/22562087.E930 N2 - The 2019 coronavirus pandemic (COVID-19) is a public health emergency of international concern, which poses a major challenge to mental health as a result of its unprecedented impact in this 21st century. Research in past epidemics has revealed a deep and wide range of psychosocial consequences at the individual and collective level. There are multiple associated psychological disturbances, ranging from isolated symptoms to complex disorders with marked impairment of functionality, such as insomnia, anxiety, depression, and post-traumatic stress disorder. Therefore, it is necessary for mental health services to develop strategies that allow them to react skillfully and provide support to health workers and the affected population so as to reduce the psychological impact as well as the development of psychiatric symptoms. The purpose of this reflection article is to show the possible consequences on the mental health of the population as a result of social isolation due to the COVID-19 pandemic. ER -