Silvia L. Gaviria

Psicopatología y género: visión longitudinal e histórica a través del DSM

Introduction: The study of gender and its effects on mental health is a fascinating and growing field of clinical research. The exclusion of women in most clinical studies has generated significant gaps in our knowledge about mental illnesses and their treatments. Objectives: (a) First, to examine relevant areas of the relationship between gender and vulnerability to mental disorders; (b) on the basis of recent research, to review the history of the use of gender in the four versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), and, finally, (c) to show the possibilities, advantages and disadvantages of an active consideration of gender in DSM-V, to be published within the next four or five years. Method: The search for studies was conducted through the following databases: PubMed, Medline, Ovid, LILACS, and SciELO. Results and conclusion: Mental illness is the result of a complex matrix of factors such as genetic profile, recent experiences and early life events, social support, religious beliefs, and, of course, gender.

Mental health law in Colombia

Mental health law in Colombia has evolved over the past 50 years, in concert with worldwide recognition and prioritisation of mental healthcare. Laws and policies have become increasingly sophisticated to accommodate the ongoing transformations throughout Colombia’s healthcare system and improvements in mental health screening, treatment and supportive care. Mental health law and policy development have been informed by epidemiological data on patterns of mental disorders in Colombia. Colombia is distinguished by the fact that its mental health laws and policies have been formulated during a 60-year period of continuous armed conflict. The mental health of Colombian citizens has been affected by population-wide exposure to violence and, accordingly, the mental health laws that have been enacted reflect this feature of the Colombian experience.

Socio-demographic patterns of posttraumatic stress disorder in Medellin, Colombia and the context of lifetime trauma exposure

ABSTRACT Colombia, South America is currently transitioning to post-conflict status following 6 decades of armed conflict. The population has experienced extensive exposures to potentially traumatic events throughout the lifespan. Sources of trauma exposure include the prolonged armed insurgency, narco-trafficking violence, urban gang violence, violent actions of criminal bands, intra-familial violence, gender-based violence, and sex trafficking. Exposure to potentially traumatic events is related to a variety of psychiatric outcomes, in particular, posttraumatic stress disorder. Given this context of lifetime trauma exposure, socio-demographic patterns of posttraumatic stress disorder were explored in a sample of residents of Medellin, Colombia, the nations second largest city and a nexus for multiple types of trauma exposure.

Mental health in Colombia

A hallmark of Colombia is population-wide exposure to violence. To understand the realities of mental health in Colombia requires attention to the historical context of 60 years of unrelenting armed conflict overlaid upon high rates of homicide, gang activity and prevalent gender-based and intra-familial violence. The number of patients affected by trauma is extremely large, and the population burden of alcohol misuse and illicit drug use is significant. These patterns have brought the subspecialties of trauma and addiction psychiatry to the forefront, and highlight the need for novel treatments that integrate psychotherapeutic and psychopharmacological modalities.

Síntomas depresivos perinatales: prevalencia y factores psicosociales asociados

Perinatal depression is a major depression episode that starts during pregnancy and the postpartum period; and is an important cause of health risks in women and infants. A cross-sectional observational study was conducted with information from the records of 112 pregnant women or in the immediate postpartum period who were surveyed to determine the possible association between perinatal depressive symptoms and psychosocial factors occurring in the last year. The prevalence of clinically significant perinatal depressive symptoms using the Edinburgh scale was of 22.36%. The logistic regression model found association between clinically significant perinatal depressive symptoms (score on the Edinburgh scale ≥ 12 and the following psychosocial factors: end of the couples relationship (OR=6.26; 95% CI, 1.91-20.49), severe economic problems (OR=6.61; 95% CI, 1.86-23.45), and the death of a family member (OR=3.79; 95% CI, 1.12-12.74). In this study one in four women had broken up with their partner and had severe economic problems during pregnancy, also one of ten had suffered the death of a loved one in the past year. These psychosocial factors were strongly associated with the presence of depressive symptoms with clinical importance. These finding offer the opportunity to consider psychosocial factors as a source of maternal stress that could be easily identified in the prenatal controls that pregnant women receive to identify women at risk of experiencing depressive symptoms in the perinatal period, which will enable appropriate treatment to be given to those who need it.

Hombres cuidadores de vida: formación en masculinidades género-sensibles para la prevención de las violencias hacia las mujeres en Medellín

The training strategies targeted at men so as to reflect on the cultural patterns of patriarchy are an alternative in the promotion of human rights, the prevention of violence towards women and the mainstreaming of gender equality in public policies. With a socio-critical pedagogical approach, we conducted a Training Certification Program in gender equality and gender-sensitive masculinities, for a group of 76 male civil servants and civic leaders in the Colombian city of Medellin, for the purpose of questioning their gender socialization in the patriarchal model, directed towards the development and execution of social, educational or communications projects. The projects proposed by the participants criticize the andro-centric, sexist and discriminatory discourses regarding women that circulate in a manner predominant in their academic, workplace and family ambits, with a gender political commitment and respect for diversity.

Artículo originalHombres cuidadores de vida: formación en masculinidades género-sensibles para la prevención de las violencias hacia las mujeres en MedellínMen caretakers of life: Training in gender-sensitive masculinities for the prevention of violence towards women in Medellin

The training strategies targeted at men so as to reflect on the cultural patterns of patriarchy are an alternative in the promotion of human rights, the prevention of violence towards women and the mainstreaming of gender equality in public policies. With a socio-critical pedagogical approach, we conducted a Training Certification Program in gender equality and gender-sensitive masculinities, for a group of 76 male civil servants and civic leaders in the Colombian city of Medellin, for the purpose of questioning their gender socialization in the patriarchal model, directed towards the development and execution of social, educational or communications projects. The projects proposed by the participants criticize the andro-centric, sexist and discriminatory discourses regarding women that circulate in a manner predominant in their academic, workplace and family ambits, with a gender political commitment and respect for diversity.

Prevalence of Alcohol Abuse and Dependence in Adults With Social Phobia in Medellin

INTRODUCTION Having a social phobia may lead to consuming alcohol for greater social assertiveness, running the risk of leading to an abuse disorder or alcohol dependence. The aim of the study was to estimate prevalence of pathological comorbidity between social phobia and alcohol consumption in adults of the city of Medellin, and the behavior of comorbidity by gender, age, presence of a father figure in childhood, and education. METHODS Secondary analysis of the database of the first Mental Health Population Survey conducted in the city of Medellin in 2011 and 2012 based on the methodology of the World Mental Health Survey guidelines and coordinated by WHO-HARVARD. RESULTS The lifetime prevalence of abuse and dependence in people with social phobia was 24.1% and 11.2%, respectively. For people with social phobia the prevalence was 13% for abuse and 4.4% for dependence (OR=2.11 for abuse, OR=2.46 for dependence). Annual prevalence of people with social phobia who abused or were dependent on alcohol was 7.8% and 5.9%, respectively, compared to those who do not suffer from this disorder, with a prevalence of 3.4% and 1.7%, respectively (OR=2.39 for abuse and OR=3.57 for dependence). DISCUSSION There was significant correlation in the annual and lifetime prevalence between social phobia and the pathological consumption of alcohol. Statistically significant relationships were found for the variables associated with social phobia, however, more work is needed to confirm or refute these associations.

Artículo originalPrevalencia de abuso y dependencia de alcohol en adultos con fobia social en MedellínPrevalence of Alcohol Abuse and Dependence in Adults With Social Phobia in Medellin

INTRODUCTION Having a social phobia may lead to consuming alcohol for greater social assertiveness, running the risk of leading to an abuse disorder or alcohol dependence. The aim of the study was to estimate prevalence of pathological comorbidity between social phobia and alcohol consumption in adults of the city of Medellin, and the behavior of comorbidity by gender, age, presence of a father figure in childhood, and education. METHODS Secondary analysis of the database of the first Mental Health Population Survey conducted in the city of Medellin in 2011 and 2012 based on the methodology of the World Mental Health Survey guidelines and coordinated by WHO-HARVARD. RESULTS The lifetime prevalence of abuse and dependence in people with social phobia was 24.1% and 11.2%, respectively. For people with social phobia the prevalence was 13% for abuse and 4.4% for dependence (OR=2.11 for abuse, OR=2.46 for dependence). Annual prevalence of people with social phobia who abused or were dependent on alcohol was 7.8% and 5.9%, respectively, compared to those who do not suffer from this disorder, with a prevalence of 3.4% and 1.7%, respectively (OR=2.39 for abuse and OR=3.57 for dependence). DISCUSSION There was significant correlation in the annual and lifetime prevalence between social phobia and the pathological consumption of alcohol. Statistically significant relationships were found for the variables associated with social phobia, however, more work is needed to confirm or refute these associations.

Prevalencia de abuso y dependencia de alcohol en adultos con fobia social en Medellín

INTRODUCTION Having a social phobia may lead to consuming alcohol for greater social assertiveness, running the risk of leading to an abuse disorder or alcohol dependence. The aim of the study was to estimate prevalence of pathological comorbidity between social phobia and alcohol consumption in adults of the city of Medellin, and the behavior of comorbidity by gender, age, presence of a father figure in childhood, and education. METHODS Secondary analysis of the database of the first Mental Health Population Survey conducted in the city of Medellin in 2011 and 2012 based on the methodology of the World Mental Health Survey guidelines and coordinated by WHO-HARVARD. RESULTS The lifetime prevalence of abuse and dependence in people with social phobia was 24.1% and 11.2%, respectively. For people with social phobia the prevalence was 13% for abuse and 4.4% for dependence (OR=2.11 for abuse, OR=2.46 for dependence). Annual prevalence of people with social phobia who abused or were dependent on alcohol was 7.8% and 5.9%, respectively, compared to those who do not suffer from this disorder, with a prevalence of 3.4% and 1.7%, respectively (OR=2.39 for abuse and OR=3.57 for dependence). DISCUSSION There was significant correlation in the annual and lifetime prevalence between social phobia and the pathological consumption of alcohol. Statistically significant relationships were found for the variables associated with social phobia, however, more work is needed to confirm or refute these associations.