Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Suicidal attempt constitutes the majority of patients with self-inflicted injuries seen at hospital emergency departments. The economic and social costs are high in terms of utilization of health services and the behavior’s impact on the individual and his/her family. Objective: To identify some epidemiological characteristics of suicide attempts at Nampula Central Hospital in Mozambique. Material and Method: Descriptive, cross-sectional study on 93 patients who attempted suicide between May 2014 and December 2016. Sociodemographic variables, suicidal method, reasons for the attempt, previous attempts, persistence of suicidal ideation, psychiatric diagnosis and whether the attempt was impulsive or not were identified, data, quantified through percent figures. Results: Over half of the patients were in the 15-24, not-married, and students with a female/male ratio of 1.3. Interpersonal conflicts were the reason in ¾ parts of the attempts. Suicidal ideation persisted in 35.5 % of the patients. Most of the suicide attempts were impulsive acts, facilitated by the availability and easy access to a rodenticide called ratex, and 14.6 % of the patients had had previous attempts. The most frequent psychiatric diagnoses were personality and depressive disorders. Conclusions: Interpersonal conflicts, availability of a lethal agent, impulsive behaviour and diagnoses of personality disorders and depression were the main descripotive findings of this study in Mozambique.

Desde la antigüedad se han descrito manifestaciones de religiosidad peri-ictal en epilepsia. Es frecuente la psicopatología asociada a epilepsia; entre otras manifestaciones, la psicosis asociada a epilepsia ha sido reportada aunque con menor frecuencia que la depresión y la ansiedad; en especial la psicosis postictal. El uso del monitoreo prolongado con Video- EEG en los últimos años  ha permitido estudiar mejor estas manifestaciones. Presentamos un caso de epilepsia del lóbulo temporal farmacorresistente, con un episodio de psicosis postictal caracterizado por delusiones de contenido religioso. Se realizó un estudio detallado que incluyó resonancia de encéfalo y Video-EEG prolongado; revisamos la literatura y los mecanismos fisiopatogénicos propuestos para este fenómeno postictal.

Objective: To determine the association between depression and the lack of adherence to antituberculosis treatment in patients treated at the National Hospital Dos de Mayo (Lima, Perú) in 2017. Material and Methods: Observational, descriptive and prospective study carried out in 50 TB patients who completed the first phase of the Sensitive treatment scheme. PHQ-9 questionnaire was applied to determine depression, and Morisky-Green questionnaire to evaluate adherence to treatment. Results: 28 male and 22 female patients with normal nutritional status, recently diagnosed with pulmonary TB were assessed. Average number of fouls was 6.5. 38% of patients were non-adherent, and depression was present in 76%., according to the instruments used. (p> 0.05). There was also a statistically significant association between adherence and having 5 or more faults during the 1st Phase. Conclusions: There is an association between adherence to anti-TB treatment and depression. Similarly, high frequency of non-adherence to treatment in the first phase and high frequency of symptoms suggestive of depression, and association between adherence and having 5 or more faults.

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Objective: To report the efficacy and long-term safety of the Vagus Nerve Stimulation (VNS), in a series of adult patients with drug-resistant focal epilepsy, treated in a hospital of Peru’s Social Security System. Methods: Data of the Adult Epilepsy Unit at Edgardo Rebagliati National Hospital, from June 2016 to June 2019, were reviewed in order to identify patients who had been implanted with VNS. Frequency of seizures and antiepileptic drugs (AED), prior to implantation with VNS, at 3 and 6 months, and at the end of the follow-up period were recorded, as were the average percentage change in the frequency of seizures, response rates of ≥ 50%, ≥75%, and changes in AED and adverse effects. Results: Five patients with drug-resistant multifocal epilepsy who were implanted with VNS for not being candidates to resective epilepsy surgery were identified. The average age was 20.6 years old. The average duration of follow-up from the implant was 21 months and the average percentage in the reduction of the seizure frequency at 3, and 6 months, and at the end of the follow-up period (21 months), was 24%, 45% and 69%, respectively. The response rates of ≥ 50% and ≥ 75% were 80% and 40%. There was a partial reduction of AED in only 1 patient. The main adverse effect was hoarseness. Conclusions: The experience with VNS, reported for the first time in Peru, demonstrates its efficacy as palliative therapy, and good safety profile in adults with drug-resistant multifocal epilepsy. The effectiveness is significantly higher with sustained long-term stimulation.

Background: The populations of patients with Type 2 Diabetes Mellitus (DM2) generally have a higher frequency of psychiatric illnesses than the general population. Objective: To identify the frequency of undiagnosed depression and anxiety in patients with DM2 who attended the outpatient clinic of a general hospital in Lima. Material and methods: A descriptive, cross-sectional study was conducted on patients with DM2, among whom the presence of depression and anxiety was determined by using the Depressive Psychopathology Scale (EPD-6) and the Lima Anxiety Scale (LAS-20). Results: From 327 patients included in the study, 23.9% had depression, 32.7% anxiety and 7.95% suicidality, whereas 5.5% presented symptoms of both, depression and anxiety. Additionally, 17.94% of patients with depression, and 16.82% of those with anxiety presented evidence of suicidality. 39.9 % of women had anxiety compared to 16.7% of men (p <0.01). The median age of patients with depression was 59 years (IQT: 51-64) versus 62 years (IQT: 54-69) among patients without depression (p=0.038). Conclusions: Almost a quarter (23.9%) of the patients with DM2 had depression, and a third (33.7%) presented anxiety. In addition, female sex and age appear to be significantly related to anxiety and depression, respectively.

Objectives: To identify the prevalence and factors associated with the Burnout Syndrome (BOS) in physicians of the Hipólito Unanue National Hospital in Lima-Peru, during 2018. Material and methods: Observational, transversal and analytical study. The initial study population was constituted by 252 doctors. A sample was selected by the stratified random sampling technique. Different socio-demographic and labor variables were recorded through an anonymous survey. For the diagnosis of BOS, the Maslach Burnout Inventory was used. The variables associated were determined by means of a logistic regression model. A value of p <0.05 was considered significant. Results: Out of 150 doctors surveyed, 23 (15.3%) showed results compatible with BOS. Sixty-five (43.3%) of the respondents reached a high level of emotional exhaustion, 69 (46%) a high level of depersonalization, and 61 (41.7%) a low level of personal accomplishment (p <0.05). The variables associated with the BOS were male sex (OR = 6.12; 95% CI: 1.43-26.13, p = 0.01) while having an additional job (OR = 0.15; 95% CI: 0.04 - 0.49, p = 0.002), could be considered a protective factor. Conclusions: A low prevalence of BOS was found among the physicians surveyed, although a significant group of them reported high levels of emotional exhaustion and depersonalization with low levels of personal accomplishment. Male sex was associated with BOS, while having an additional job showed a possible protective effect.

Objective: To describe the frequency of depressive symptomatology in caregivers of pediatric patients on peritoneal dialysis and hemodialysis. Material and methods: Descriptive, cross-sectional study of 33 caregivers of pediatric patients with Chronic Kidney Disease, under treatment in the Hemodialysis and Peritoneal Dialysis Unit of the Cayetano Heredia Hospital in Lima (Peru). The participants completed the Patient Health Questionnaire (PHQ-9), which assessed their degree of depressive symptomatology. Results: A total of 54.54% of caregivers showed depressive symptomatology; 9.09% moderately severe, 18.18% moderate and 27.27% mild; only 3.03% reported intake of antidepressants. All caregivers with moderate and moderately severe depression reported some degree of difficulty in performing their tasks. Conclusions: A high frequency of depressive symptomatology in caregivers of pediatric patients on dialysis was found. The recognition of depression in primary caregivers is important, in order to carry out interventions aimed at maintaining their emotional well-being.

There is an erroneous perception that Electroconvulsive Therapy (ECT) should be used as a last resource of psychiatric management and only in chronic and refractory cases. This, among other causes, has led to an unfortunate decrement in its use during recent times both in our country and in other places. However, acute psychoses with catatoniform or motility symptoms have high favorable response rates, up to 100%, and ECT should, therefore, be a first line treatment resource for these disorders in order to prevent or avoid the occurrence of catatonia´s ominous consequences. The case of a patient with diagnosis of acute polymorphic psychotic disorder without symptoms of schizophrenia (F23.0, ICD-10) is presented. The patient achieved a complete remission of his catatonic and psychotic symptoms with a single session of ECT – an infrequent event by itself-. On this basis, e review of pertinent literature is conducted, and it is concluded that the ECT should resume its relevance in the management of acute cases with a good prognosis, as its postponement would bring up unnecessarily negative consequences.