Rafael Vásquez

Trastorno obsesivo compulsivo en niños y adolescentes

Background: Obsessive-compulsive disorder (OCD) in children and adolescents is a complex disease. It is considered the fourth most common psychiatric disorder in the world, with relevant biopsychosocial morbidity and a prevalence of 1-3% of the world population; it is defined by the World Health Organization as the tenth most disabling illness. Objective: To review approaches in the scientific literature and updates on natural history, course, diagnosis, and treatment of OCD in children and adolescents. Method: Search in PubMed and LILACS databases, from 2005. Results: No Colombian update articles dealing with this subject were found

Trastornos psiquiátricos en pacientes pediátricos con lupus eritematoso sistémico en un hospital de referencia

OBJECTIVE To describe the psychiatric manifestations in pediatric patients with systemic erythematous lupus seen in the Fundación Hospital de la Misericordia. METHODS Observational descriptive study. Medical charts and test results of inpatients and outpatients between 2007 and2013 were reviewed; 39 patients were selected. SPSS 19 was used for statistical analysis. Statistical significance was considered with P=.05. RESULTS Mean age was 13.7 (2.33), with 78.9% female. The most frequent psychiatric manifestation was anxiety (52.6%), followed by adjustment disorder and depression (36.8% each one), psychosis (10%), conversion disorder (7.9%), and obsessive compulsive disorder (5.3%). The mean SLICC score was 2.76 (2.8), and the mean SLEDAI score was 20.81 (20.82). Antinuclear antibodies were positive in 81.25%. Neuropsychiatric lupus was diagnosed in 65.8% of patients; seizures were observed in 23.7%, headache in 36.8%, stroke in 13.2%, vasculitis, chorea 5.3%, and meningitis 5.3% of patients. The mean time from lupus diagnosis was 20.47 (22.2) months, with the shortest period for adjustment disorder and the longest period in patients with conversion disorder (pseudo-seizures) being 15 months and 31 months, respectively. The highest SLEDAI score was in patients with psychosis (35.5 [16.21] vs 19.08 [13.72]; P=.032), and also the highest disease damage (SLICC, 4.25 [4.03] vs 2.58 [2.67]; P=.27) in comparison with the other manifestations. CONCLUSIONS The most frequent psychiatric manifestations were anxiety, depression, and adjustment disorder, with a higher frequency than other studies, and with lupus activity principally in patients with psychosis.

Qué es la hiperactividad y cómo ven el problema los padres

Resumen Introduccion El trastorno por deficit de atencion con hiperactividad (TDAH) es el diagnostico mas frecuente en la consulta psiquiatrica infantil en distintas sociedades. Clasicamente, la triada de hiperactividad, deficit de atencion e impulsividad es el nucleo y el objetivo de las diferentes estrategias terapeuticas. Sin embargo, son multiples los motivos de consulta que los pacientes y sus familias establecen, debido al impacto de los sintomas en las dinamicas escolares y de convivencia. Objetivo Conocer como se expresan los motivos de consulta en un medio como el de Bogota (Colombia). Metodos Se analizaron 366 encuestas de padres de ninos con TDAH, quienes asisten a la reunion mensual de la escuela para padres HIDEA, especializada en TDAH, en la que relatan sus motivos de consulta y las estrategias con las cuales tratan de mejorar estas dificultades. Resultados Las quejas mas frecuentes son la rebeldia, el desacato a la autoridad y el bajo rendimiento escolar. Para ayudar al nino, recurren ante todo a la terapia ocupacional, de acuerdo con la recomendacion del colegio. Conclusiones Para los padres la problematica sentida no se relaciona directamente con los rasgos clinicos principales del TDAH, sino con sus consecuencias desadaptativas en el medio escolar. Paradojicamente, tambien se hace evidente una relativa debilidad de las estrategias de afrontamiento que implican cambios profundos en los patrones de crianza y convivencia.Introduction The most frequent clinical diagnosis in psychiatric child services in different societies is attention deficit hyperactivity disorder (ADHD). Classically, the core symptoms and the main objective of different therapeutic strategies are the triad hyperactivity, attention deficit, and impulsivity. However, the chief complaints that patients and families state are diverse due to the relevant impact of the symptoms on school and social dynamics.

Estudio de variantes de los genes BDNF, COMT, DAT1 y SERT en niños colombianos con déficit de atención

BACKGROUND Attention deficit and hyperactive disorder (ADHD) is highly prevalent among children in Bogota City. Both genetic and environmental factors play a very important role in the etiology of ADHD. However, to date few studies have addressed the association of genetic variants and ADHD in the Colombian population. OBJECTIVES To test the genetic association between polymorphisms in the DAT1, HTTLPR, COMT and BDNF genes and ADHD in a sample from Bogota City. METHODS We genotyped the most common polymorphisms in DAT1, SERT, COMT and BDNF genes associated with ADHD using conventional PCR followed by restriction fragment length polymorphism (RFLP) in 97 trios recruited in a medical center in Bogota. The transmission disequilibrium test (TDT) was used to determine the association between such genetic variants and ADHD. RESULTS The TDT analysis showed that no individual allele of any variant studied has a preferential transmission. CONCLUSIONS Our results suggest that the etiology of the ADHD may be complex and involves several genetic factors. Further studies in other candidate polymorphisms in a larger sample size will improve our knowledge of the ADHD in Colombian population.

Aproximación crítica a los trastornos somatomorfos en niños

Somatomorphic disorders have common somatic manifestations without medical explanation, that can affect daily life. There are evaluation difficulties regarding symptom report or observation in children due to their age, parental influence and associated factors. The aim of this work is to acknowledge diagnosis difficulties and clinic tools to approach somatomorphic disorders in children. A systematic search in the information published for the last ten years was carried out. Historical evolution of the concept of somatization has generated difficulties to approach this issue. Some signs could indicate a somatomorphic disorder; however, there are very little evaluating tools for children. Currently, said tools are only based on lists of symptoms without fully answering to all questions. Somatomorphic disorders or somatic symptoms in children are still a gap to be closed.Somatomorphic disorders have common somatic manifestations without medical explanation, that can affect daily life. There are evaluation difficulties regarding symptom report or observation in children due to their age, parental influence and associated factors. The aim of this work is to acknowledge diagnosis difficulties and clinic tools to approach somatomorphic disorders in children. A systematic search in the information published for the last ten years was carried out. Historical evolution of the concept of somatization has generated difficulties to approach this issue. Some signs could indicate a somatomorphic disorder; however, there are very little evaluating tools for children. Currently, said tools are only based on lists of symptoms without fully answering to all questions. Somatomorphic disorders or somatic symptoms in children are still a gap to be closed.

Artículos originales¿Qué es la hiperactividad y cómo ven el problema los padres?: Análisis de los motivos de consulta y las estrategias de afrontamiento del TDAH en una muestra de estratos socioeconómicos altos de BogotáWhat is Hyperactivity and How do Parents View The Problem?: Analysis of Chief Complaints and Coping Strategies of Adhd in a Sample of High Socioeconomic Status in Bogotá

Resumen Introduccion El trastorno por deficit de atencion con hiperactividad (TDAH) es el diagnostico mas frecuente en la consulta psiquiatrica infantil en distintas sociedades. Clasicamente, la triada de hiperactividad, deficit de atencion e impulsividad es el nucleo y el objetivo de las diferentes estrategias terapeuticas. Sin embargo, son multiples los motivos de consulta que los pacientes y sus familias establecen, debido al impacto de los sintomas en las dinamicas escolares y de convivencia. Objetivo Conocer como se expresan los motivos de consulta en un medio como el de Bogota (Colombia). Metodos Se analizaron 366 encuestas de padres de ninos con TDAH, quienes asisten a la reunion mensual de la escuela para padres HIDEA, especializada en TDAH, en la que relatan sus motivos de consulta y las estrategias con las cuales tratan de mejorar estas dificultades. Resultados Las quejas mas frecuentes son la rebeldia, el desacato a la autoridad y el bajo rendimiento escolar. Para ayudar al nino, recurren ante todo a la terapia ocupacional, de acuerdo con la recomendacion del colegio. Conclusiones Para los padres la problematica sentida no se relaciona directamente con los rasgos clinicos principales del TDAH, sino con sus consecuencias desadaptativas en el medio escolar. Paradojicamente, tambien se hace evidente una relativa debilidad de las estrategias de afrontamiento que implican cambios profundos en los patrones de crianza y convivencia.Introduction The most frequent clinical diagnosis in psychiatric child services in different societies is attention deficit hyperactivity disorder (ADHD). Classically, the core symptoms and the main objective of different therapeutic strategies are the triad hyperactivity, attention deficit, and impulsivity. However, the chief complaints that patients and families state are diverse due to the relevant impact of the symptoms on school and social dynamics.

¿Qué es la hiperactividad y cómo ven el problema los padres?: Análisis de los motivos de consulta y las estrategias de afrontamiento del TDAH en una muestra de estratos socioeconómicos altos de Bogotá

Resumen Introduccion El trastorno por deficit de atencion con hiperactividad (TDAH) es el diagnostico mas frecuente en la consulta psiquiatrica infantil en distintas sociedades. Clasicamente, la triada de hiperactividad, deficit de atencion e impulsividad es el nucleo y el objetivo de las diferentes estrategias terapeuticas. Sin embargo, son multiples los motivos de consulta que los pacientes y sus familias establecen, debido al impacto de los sintomas en las dinamicas escolares y de convivencia. Objetivo Conocer como se expresan los motivos de consulta en un medio como el de Bogota (Colombia). Metodos Se analizaron 366 encuestas de padres de ninos con TDAH, quienes asisten a la reunion mensual de la escuela para padres HIDEA, especializada en TDAH, en la que relatan sus motivos de consulta y las estrategias con las cuales tratan de mejorar estas dificultades. Resultados Las quejas mas frecuentes son la rebeldia, el desacato a la autoridad y el bajo rendimiento escolar. Para ayudar al nino, recurren ante todo a la terapia ocupacional, de acuerdo con la recomendacion del colegio. Conclusiones Para los padres la problematica sentida no se relaciona directamente con los rasgos clinicos principales del TDAH, sino con sus consecuencias desadaptativas en el medio escolar. Paradojicamente, tambien se hace evidente una relativa debilidad de las estrategias de afrontamiento que implican cambios profundos en los patrones de crianza y convivencia.Introduction The most frequent clinical diagnosis in psychiatric child services in different societies is attention deficit hyperactivity disorder (ADHD). Classically, the core symptoms and the main objective of different therapeutic strategies are the triad hyperactivity, attention deficit, and impulsivity. However, the chief complaints that patients and families state are diverse due to the relevant impact of the symptoms on school and social dynamics.

Research on a shoestring in Colombia

EDITOR—Medical research in Colombia is a joint effort between two sectors: education and health. These two sectors, however, have low budgets that continue to be reduced, which is reflected in the number of research projects. In Colombia most medical research is carried out within the universities, but, although 70% of university education is privately run, most of the research is government funded. Thus closures of public universities and hospitals and cut backs in their budgets …