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      Trastornos mentales en estudiantes de medicina humana en tres universidades de Lambayeque, Perú Translated title: Mental disorders in medical students of three universities in Lambayeque, Peru

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          Abstract

          Los trastornos de salud mental son un problema muy frecuente en la población actual, sobre todo en alumnos de educación superior que, de acuerdo a algunos estudios, pueden mostrar mayor predisposición a problemas emocionales y psicosociales. Objetivos: Describir los trastornos mentales más frecuentes en estudiantes de medicina de tres universidades de Lambayeque, durante el año 2012. Material y métodos: Estudio descriptivo transversal. La población fue de 998 alumnos distribuidos según año de estudio académico, elegidos mediante muestreo consecutivo. Se utilizó el Test Mini International Neuropsychiatric Interview (MINI) como tamizaje. Se realizó un análisis descriptivo y un análisis bivariado exploratorio determinando razones de prevalencia con un IC 95%, usando chi2 y el test de Fisher. Se usó el Software STATA versión 11. Resultados: Se entrevistó un total de 284 alumnos, la media de edad fue de 21,05 ± 3,8 años, 57,4% fueron mujeres, 98,2% solteros, 61% cursaban ciencias básicas, 6,7% tenían diagnóstico previo de depresión y 7,4% tenían diagnóstico previo de ansiedad; 140 estudiantes (49,07%) reportaron por lo menos un trastorno mental (TM). Los trastornos mentales con mayor prevalencia fueron episodio hipomaniaco (19,7%) y episodio depresivo (17,3%). En el análisis bivariado se encontraron asociaciones entre alguna forma de trastorno mental y edad, estudiar en una universidad privada y cursar estudios de ciencias básicas. Conclusiones: En estudiantes de medicina de Lambayeque se han encontrado prevalencias frecuentes de episodios hipomaniaco y depresivo mayor, y de riesgo suicida. Deben conducirse mayores y más profundos estudios de corte epidemiológico en este tipo de población.

          Translated abstract

          Mental health disorders are a fairly frequent problem in several segments of today’s population, particularly among higher education students who, according to some inquiries, seem to be more prone to emotional and psychosocial problems. Objectives: To describe the most frequent mental disorders in medical students from three universities from Lambayeque, Perú, during the year 2012. Material and methods: Cross sectional study. The population under scrutiny included 998 students distributed by year of academic classes and chosen by consecutive sampling. The Mini International Neuropsychiatric Interview (MINI) for screening of mental disorders was used. A descriptive analysis and an exploratory bivariate analysis with 95 % confidence intervals using chi2 and Fisher’s tests, were performed. Software STATA version 11 was used. Results: A total of 284 students were interviewed, the average age was 21.05 ± 3.8 years, 57.4 % were women, 98.2 % single, 61 % were enrolled in basic sciences, 6.7% had a prior diagnosis of depression, and 7.4 % h of anxiety; 140 students (49.07 %) reported at least one mental disorder. The most prevalent disorders were hypomanic episode (19.7%), and major depressive episode (17.3%). In the bivariate analysis, the presence of a mental disorder was associated with age, studyingin a private university, and being a basic science student. Conclusions: Mental disorders among medical students from Lambayeque seem to be highly prevalent, the more frequent ones being hypomanic and major depressive episodes, and suicidal risk. More comprehensive, extended and deeper studies of this nature are needed in this specific population.

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          Most cited references34

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          Gender differences in mental disorders, including more anxiety and mood disorders among women and more externalizing disorders among men, are found consistently in epidemiological surveys. The gender roles hypothesis suggests that these differences narrow as the roles of women and men become more equal. To study time-space (cohort-country) variation in gender differences in lifetime DSM-IV mental disorders across cohorts in 15 countries in the World Health Organization World Mental Health Survey Initiative and to determine if this variation is significantly related to time-space variation in female gender role traditionality as measured by aggregate patterns of female education, employment, marital timing, and use of birth control. Face-to-face household surveys. Africa, the Americas, Asia, Europe, the Middle East, and the Pacific. Community-dwelling adults (N = 72,933). The World Health Organization Composite International Diagnostic Interview assessed lifetime prevalence and age at onset of 18 DSM-IV anxiety, mood, externalizing, and substance disorders. Survival analyses estimated time-space variation in female to male odds ratios of these disorders across cohorts defined by the following age ranges: 18 to 34, 35 to 49, 50 to 64, and 65 years and older. Structural equation analysis examined predictive effects of variation in gender role traditionality on these odds ratios. In all cohorts and countries, women had more anxiety and mood disorders than men, and men had more externalizing and substance disorders than women. Although gender differences were generally consistent across cohorts, significant narrowing was found in recent cohorts for major depressive disorder and substance disorders. This narrowing was significantly related to temporal (major depressive disorder) and spatial (substance disorders) variation in gender role traditionality. While gender differences in most lifetime mental disorders were fairly stable over the time-space units studied, substantial intercohort narrowing of differences in major depression was found to be related to changes in the traditionality of female gender roles. Additional research is needed to understand why this temporal narrowing was confined to major depression.
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            Despite the high morbidity associated with bipolar disorder (BP), few studies have prospectively studied the course of this illness in youth. To assess the longitudinal course of BP spectrum disorders (BP-I, BP-II, and not otherwise specified [BP-NOS]) in children and adolescents. Subjects were interviewed, on average, every 9 months for an average of 2 years using the Longitudinal Interval Follow-up Evaluation. Outpatient and inpatient units at 3 university centers. Two hundred sixty-three children and adolescents (mean age, 13 years) with BP-I (n = 152), BP-II (n = 19), and BP-NOS (n = 92). Rates of recovery and recurrence, weeks with syndromal or subsyndromal mood symptoms, changes in symptoms and polarity, and predictors of outcome. Approximately 70% of subjects with BP recovered from their index episode, and 50% had at least 1 syndromal recurrence, particularly depressive episodes. Analyses of weekly mood symptoms showed that 60% of the follow-up time, subjects had syndromal or subsyndromal symptoms with numerous changes in symptoms and shifts of polarity, and 3% of the time, psychosis. Twenty percent of BP-II subjects converted to BP-I, and 25% of BP-NOS subjects converted to BP-I or BP-II. Early-onset BP, BP-NOS, long duration of mood symptoms, low socioeconomic status, and psychosis were associated with poorer outcomes and rapid mood changes. Secondary analyses comparing BP-I youths with BP-I adults showed that youths significantly more time symptomatic and had more mixed/cycling episodes, mood symptom changes, and polarity switches. Youths with BP spectrum disorders showed a continuum of BP symptom severity from subsyndromal to full syndromal with frequent mood fluctuations. Results of this study provide preliminary validation for BP-NOS.
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              Gender differences in unipolar depression: an update of epidemiological findings and possible explanations.

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              To give an update on epidemiological findings on sex differences in the prevalence of unipolar depression and putative risk factors. Systematic review of the literature. Recent epidemiological research yields additional evidence for a female preponderance in unipolar depression, holding true across different cultural settings. Current explanations include artefacts, genetic, hormonal, psychological and psychosocial risk factors. Rather consistently, intrapsychic and psychosocial gender role related risk factors have been identified which may contribute to the higher depression risk in women. Gender role aspects are also reflected in endocrine stress reactions and possibly influence associated neuropsychological processes. There is a need for more integrative models taking into account psychological, psychosocial, and macrosocial risk factors as well as their interactions, which also connect these factors with physiological and endocrine responses. Furthermore, it is conceivable that across the life span, as well as across cultural settings, individual risk factors will add with varying emphasis to the higher prevalence of depression in women.
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                Author and article information

                Journal
                rnp
                Revista de Neuro-Psiquiatría
                Rev Neuropsiquiatr
                Universidad Peruana Cayetano Heredia. Facultad de Medicina (Lima, , Peru )
                0034-8597
                October 2016
                : 79
                : 4
                : 197-206
                Affiliations
                [01] Lambayeque orgnameUniversidad Católica Santo Toribio de Mogrovejo orgdiv1Escuela de Medicina Perú
                Article
                S0034-85972016000400002 S0034-8597(16)07900400002
                10.20453/rnp.v79i4.2974
                71f703c6-85fa-46c7-8b78-b3c684cad5e8

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 10 November 2015
                : 02 December 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 10
                Product

                SciELO Peru

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                Artículos originales

                depresión,Mental disorders,medical students,depression,anxiety,Trastornos mentales,estudiantes de medicina,ansiedad

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