Objectives We determined the validity and reliability of the Spanish translation Sheffield Profile for Assessment and Referral for Care (SPARC-Sp) questionnaire to identify the palliative care (PC) needs of patients with chronic noncommunicable diseases (NCDs) in Colombia.Methods We developed a cross-sectional observational study of scale assessment in adults with the aim of determining the validity and reliability of the SPARC-Sp questionnaire to identify the PC needs of patients with NCDs receiving outpatient or inpatient care at the Hospital Universitario San Jose of Popayan - ESE, Colombia, from 2021 to 2022.Results We applied a questionnaire consisting of demographic, clinical data, and SPARC-Sp to 507 participants. The constructed model explained 75% of the variance with an adequate fit according to the root mean square residual (0.03), the comparative fit index (0.98), and acceptable reliability (McDonald's total omega 0.4-0.9). Opportunities for improvement are the reformulation and inclusion of particular words to improve the representativeness and clarity of the domains of communication and information, religious, and spiritual issues.Significance of results This research represents the first validation of SPARC in Spanish. SPARC-Sp is an instrument that allows initiating a conversation of the patient's main needs through a systematic assessment of the patients' main needs. Its psychometric validation demonstrated good fit and acceptable reliability.

BACKGROUND:Little is known about the incidence of delirium and its subtypes in patients admitted to different departments of university hospitals in Latin America. OBJECTIVE:To determine the incidence of delirium and the frequency of its subtypes, as well as its associated factors, in patients admitted to different departments of a university hospital in Bogotá, Colombia. METHODS:A cohort of patients over 18 years of age admitted to the internal medicine (IM), geriatrics (GU), general surgery (GSU), orthopaedics (OU) and intensive care unit (ICU) services of a university hospital was followed up between January and June 2018. To detect the presence of delirium, we used the CAM (Confusion Assessment Method) and the CAM-ICU if the patient had decreased communication skills. The delirium subtype was characterised using the RASS (Richmond Agitation and Sedation Scale). Patients were assessed on their admission date and then every two days until discharged from the hospital. Those in whom delirium was identified were referred for specialised intra-institutional interdisciplinary management. RESULTS:A total of 531 patients admitted during the period were assessed. The overall incidence of delirium was 12% (95% CI, 0.3-14.8). They represented 31.8% of patients in the GU, 15.6% in the ICU, 8.7% in IM, 5.1% in the OU, and 3.9% in the GSU. The most frequent clinical display was the mixed subtype, at 60.9%, followed by the normoactive subtype (34.4%) and the hypoactive subtype (4.7%). The factors most associated with delirium were age (adjusted RR = 1.07; 95% CI, 1.05-1.09), the presence of four or more comorbidities (adjusted RR = 2.04; 95% CI, 1.31-3.20), and being a patient in the ICU (adjusted RR = 2.02; 95% CI, 1.22-3.35). CONCLUSIONS:The incidence of delirium is heterogeneous in the different departments of the university hospital. The highest incidence occurred in patients that were admitted to the GU. The mixed subtype was the most frequent one, and the main associated factors were age, the presence of four or more comorbidities, and being an ICU patient.

Background: Childhood leukemia (CL) is the most prevalent form of pediatric cancer on a global scale. However, there is a limited understanding of the dynamics of CL incidence in South America, with a specific knowledge gap in Colombia. This study aimed to identify trends in CL incidence and to analyze the effects of age, period, and birth cohort on the risk of leukemia incidence in this population. Methods: Information on all newly diagnosed leukemia cases (in general and by subtype) among residents aged 0-18 years and living in the serving areas of population -based cancer registries of Cali (2008-2017), Bucaramanga (2000-2017), Manizales (2003-2017), and Pasto (1998-2018). Estimated annual percent changes (EAPC) in incidence over time and potential changes in the slope of these EAPCs were calculated using joinpoint regression models. The effects of age, period, and cohort in CL incidence trends were evaluated using age-periodcohort models addressing the identifiability issue through the application of double differences. Results: A total of 966 childhood leukemia cases were identified. The average standardized incidence rate (ASIR) of leukemia was calculated and expressed per 100,000 person -years - observing ASIR of 4.46 in Cali, 7.27 in Bucaramanga, 3.89 in Manizales and 4.06 in Pasto. Concerning CL trends there were no statistically significant changes in EAPC throughout the different periods, however, when analyzed by leukemia subtype, statistically significant changes were observed in the EAPC for both ALL and AML. Analysis of age-period-cohort models revealed that age-related factors significantly underpin the incidence trends of childhood leukemia in these four Colombian cities. Conclusions: This study offers valuable insights into the incidence trends of childhood leukemia in four major Colombian cities. The analysis revealed stable overall CL incidence rates across varying periods, predominantly influenced by age-related factors and the absence of cohort and period effects. This information is useful for surveillance and planning purposes for CL diagnosis and treatment in Colombia.

Sperm motility is directly related to the ability of sperm to move through the female reproductive tract to reach the ovum. Sperm motility is a complex trait that is influenced by environmental and genetic factors and is associated with male fertility, oocyte penetration rate, and reproductive success of cattle. In this study we carried out a GWAS in Italian Holstein bulls to identify candidate regions and genes associated with variations in progressive and total motility (PM and TM, respectively). After quality control, the final data set consisted of 5,960 records from 949 bulls having semen collected in 10 artificial insemination stations and genotyped at 412,737 SNPs (call rate >95%; minor allele frequency >5%). (Co)variance components were estimated using single trait mixed models, and associations between SNPs and phenotypes were assessed using a genomic BLUP approach. Ten windows that explained the greatest percentage of genetic variance were located on Bos taurus autosomes 1, 2, 4, 6, 7, 23, and 26 for TM and Bos taurus autosomes 1, 2, 4, 6, 8, 16, 23, and 26 for PM. A total of 150 genes for TM and 72 genes for PM were identified within these genomic regions. Gene Ontology enrichment analyses identified significant Gene Ontology terms involved with energy homeostasis, membrane functions, sperm-egg interactions, protection against oxidative stress, olfactory receptors, and immune system. There was significant enrichment of quantitative trait loci for fertility, calving ease, immune response, feed intake, and carcass weight within the candidate windows. These results contribute to understanding the architecture of the genetic control of sperm motility and may aid in the development of strategies to identify subfertile bulls and improve reproductive success.

En este artículo se introducen los ensayos clínicos aleatorizados y conceptos básicos de la inferencia estadística. Se presenta como calcular el tamaño de muestra por tipo de desenlace e hipótesis a probar, junto con el código en el lenguaje de programación R para realizar su aplicación. Se presentan cuatro métodos para realizar el ajuste del tamaño de muestra original, cuando se planean análisis interinos. De una manera sencilla y concreta se busca realizar una introducción a estos temas, considerando las expresiones matemáticas que soportan los resultados y su implementación en programas estadísticos disponibles. Con el fin de acercar a los estudiantes de áreas de la salud a la estadística y al uso de programas estadísticos, aspectos poco considerados en su formación.

This article introduces randomized clinical trials and basic concepts of statistical inference. We present methods for calculating the sample size by outcome type and the hypothesis to be tested, together with the code in the R programming language. We describe four methods for adjusting the original sample size for interim analyses. We sought to introduce these topics in a simple and concrete way, considering the mathematical expressions that support the results and their implementation in available statistical programs; therefore, bringing health students closer to statistics and the use of statistical programs, which are aspects that are rarely considered during their training.

El espejo de la pandemia ha permitido rescatar diferentes formas de análisis de la realidad social en salud, de manera que, para el caso de esta obra, se conjugue el juicioso análisis epidemiológico de la Encuesta Nacional de Salud Mental de 2 015 con la aproximación desde las ciencias sociales, la lectura de determinantes contextuales y, en particular, la descripción que permite el análisis espacial. Todo ello se concreta en el Atlas de salud mental de Colombia que aquí presentamos, fruto del trabajo mancomunado de nuestras dos comunidades científicas, la de la Pontificia Universidad Javeriana y la Universidad Externado de Colombia.

The impact of COVID-19 pandemic on mental health of adolescents are emerging and require particular attention in settings where challenges like armed conflict, poverty and internal displacement have previously affected their mental wellbeing. This study aimed to determine the prevalence of anxiety symptoms, depressive symptomatology, probable post-traumatic stress disorder and resilience in school-attending adolescents in a post-conflict area of Tolima, Colombia during the COVID-19. A cross-sectional study was carried out with 657 adolescents from 12 to 18 years old, recruited by convenience sampling in 8 public schools in the south of Tolima, Colombia, who completed a self-administered questionnaire. Mental health information was obtained through screening scales for anxiety symptoms (GAD-7), depressive symptomatology (PHQ-8), probable post-traumatic stress disorder (PCL-5) and resilience (CD-RISC-25). The prevalence observed for moderate to severe anxiety symptoms was 18.9% (95% CI16.0-22.1) and for moderate to severe depressive symptomatology was 30.0% (95% CI26.5-33.7). A prevalence of probable post-traumatic stress disorder (PTSD) of 22.3% (95% CI18.1-27.2) was found. The CD-RISC-25 results for resilience had a median score of 54 [IQR 30]. These results suggest that approximately two-thirds of school-attending adolescents in this post-conflict area experienced at least one mental health problem such as anxiety symptoms, depressive symptomatology or probable PTSD during the COVID-19 pandemic. Future studies are of interest to establish the causal relationship between these findings and the impact of the pandemic. These findings highlight the challenge that schools have after pandemic to address the mental health of their students in order to promoting adequate coping strategies and implement prompt multidisciplinary interventions to reduce the burden of mental health problems in adolescents.

Objetivos Caracterizar la salud mental de la población de Bogotá (Colombia), a partir de información de la última Encuesta Nacional de Salud Mental (2015). Metodología Analizamos cuantitativamente la información de población residente en Bogotá recolectada en la Encuesta Nacional de Salud Mental (2015) para calcular la prevalencia de problemas y trastornos de salud mental, así como de consumo de sustancias psicoactivas con sus intervalos de confianza del 95 %. El análisis se estratificó por grupos etarios. Resultados Encontramos lo siguiente: a) un autorreporte de problemas de salud mental del 12 % (IC95 %: 9,1-15,6) y 7,9 % (IC95 %: 5,3-11,8) para los adultos y adolescentes encuestados, respectivamente; b) 9,8 % (IC95 %: 7,4-12,9) y 4,6 % (IC95 %: 2,7-7,7) con alto número de síntomas de ansiedad en adultos y adolescentes, respectivamente; c) presencia de un número alto de síntomas depresivos en el 6,7 % (IC95 %: 4,9-9,0) y 3,5 % (IC95 %: 2,0-6,1) de la población de adultos y adolescentes respectivamente; d) 12,9 % (IC95 %: 10 %-16,4 %) de los adultos y el 8,5 % (IC95 %: 5,5 %-12,8 %) de los adolescentes había presentado “cualquier trastorno de salud mental” en la vida; e) consumo de alcohol en algún momento de la vida en el 43,8 % (IC95 %: 39,1-48,7) y consumo de marihuana en un 5,6 % (IC95 %: 3,7-8,5) alguna vez en la vida. Conclusiones La población bogotana reporta prevalencias distintas a las de otros lugares del país y de otras capitales en la región. Esta caracterización permitirá guiar el desarrollo de políticas de prevención y mitigación en la ciudad, teniendo en cuenta que Bogotá agrupa un gran porcentaje de población de diversos orígenes y culturas.

Background Educational settings are ideal for promoting mental well-being and resilience in children. The challenges of the COVID-19 pandemic made evident the important role that teachers and school counselors play in the mental health of their students. Therefore, it is imperative to develop and implement cost-effective interventions that allow them to identify and address mental health problems early, especially in post–armed conflict areas, to reduce the burden of mental disorders in this population. Objective This study aimed to adapt an existing patient-focused digital intervention called DIALOG+ from an adult clinical setting to an adolescent educational setting and to assess the feasibility, acceptability, and estimated effect of implementing this intervention as a tool for promoting quality of life, mental well-being, and resilience. Methods We conducted an exploratory mixed methods study in 2 public schools in postconflict areas in Tolima, Colombia. This study was conducted in 3 phases. In the adaptation phase, focus groups were conducted with students and teachers to identify changes required in DIALOG+ for it to be used in the school setting. The exploration phase consisted of an exploratory cluster randomized controlled trial. A total of 14 clusters, each with 1 teacher and 5 students, were randomly allocated to either the experimental (DIALOG+S) group or to an active control group (counseling as usual). Teachers in both groups delivered the intervention once a month for 6 months. Through screening scales, information was collected on mental health symptoms, quality of life, self-esteem, resilience, and family functionality before and after the intervention. Finally, the consolidation phase explored the experiences of teachers and students with DIALOG+S using focus group discussions. Results The changes suggested by participants in the adaptation phase highlighted the central importance of the school setting in the mental health of adolescents. In the exploratory phase, 70 participants with a mean age of 14.69 (SD 2.13) years were included. Changes observed in the screening scale scores of the intervention group suggest that the DIALOG+S intervention has the potential to improve aspects of mental health, especially quality of life, resilience, and emotional symptoms. The consolidation phase showed that stakeholders felt that using this intervention in the school setting was feasible, acceptable, and an enriching experience that generated changes in the perceived mental health and behavior of participants. Conclusions Our results are encouraging and show that the DIALOG+S intervention is feasible and acceptable as a promising opportunity to promote well-being and prevent and identify mental health problems in the school context in a postconflict area in Colombia. Larger, fully powered studies are warranted to properly assess the efficacy and potential impact of the intervention and to refine implementation plans. Trial Registration International Standard Randomised Controlled Trial Number (ISRCTN) registry ISRCTN14396374; https://www.isrctn.com/ISRCTN14396374 International Registered Report Identifier (IRRID) RR2-10.2196/40286

Poco se conoce acerca de la incidencia del delirio en pacientes hospitalizados en diferentes servicios de hospitales universitarios en Latinoamérica y de los subtipos que se presentan. Determinar la incidencia del delirio, la frecuencia de los subtipos motores y los factores asociados en pacientes hospitalizados en diferentes servicios de un hospital universitario en Bogotá, Colombia. Se dio seguimiento a una cohorte de pacientes mayores de 18 años hospitalizados en los servicios de Medicina Interna, Geriatría, Cuidado Intensivo, Cirugía General y Ortopedia de un hospital universitario entre enero y junio de 2018. Para identificar la presencia de delirio, se utilizó la escala CAM (Confusion Assessment Method) y la CAM-ICU si el paciente presentaba disminución de las capacidades de comunicación. El subtipo de delirio se caracterizó utilizando la escala RASS (Richmond Agitation and Sedation Scale). Los pacientes fueron valorados el día de ingreso y luego cada 2 días hasta su alta hospitalaria. Se derivó a los pacientes en quienes se identificó delirio para tratamiento especializado interdisciplinario intrainstitucional. Se evaluó a 531 pacientes que ingresaron durante ese periodo a los servicios mencionados. La incidencia global del delirio fue del 12% (IC95%, 0,3-14,8). En orden descendiente, el 31,8% de los pacientes hospitalizados en el servicio de Geriatría, el 15,6% en Cuidado Intensivo, el 8,7% en Medicina Interna, el 5,1% en Ortopedia y el 3,9% en Cirugía. El subtipo motor más frecuente fue el mixto (60,9%), seguido por el normoactivo (34,4%) y el hipoactivo (4,7%). Los factores asociados con la incidencia del delirio fueron la edad (RR ajustada = 1,07; IC95%, 1,05-1,09), la presencia de 4 o más comorbilidades (RR ajustada = 2,04; IC95%, 1,31-3,20) y la hospitalización en Cuidado Intensivo (RR ajustada = 2,02; IC95%, 1,22-3,35). La incidencia del delirio es heterogénea en los diferentes servicios del hospital universitario. La mayor incidencia se presentó en pacientes ingresados en el servicio de Geriatría; el subtipo más frecuente fue el mixto y los principales factores asociados fueron la edad, la presencia de 4 o más comorbilidades y la hospitalización en Cuidado Intensivo. Little is known about the incidence of delirium and its subtypes in patients admitted to different departments of university hospitals in Latin America. To determine the incidence of delirium and the frequency of its subtypes, as well as its associated factors, in patients admitted to different departments of a university hospital in Bogotá, Colombia. A cohort of patients over 18 years of age admitted to the internal medicine (IM), geriatrics (GU), general surgery (GSU), orthopaedics (OU) and intensive care unit (ICU) services of a university hospital was followed up between January and June 2018. To detect the presence of delirium, we used the CAM (Confusion Assessment Method) and the CAM-ICU if the patient had decreased communication skills. The delirium subtype was characterised using the RASS (Richmond Agitation and Sedation Scale). Patients were assessed on their admission date and then every two days until discharged from the hospital. Those in whom delirium was identified were referred for specialised intra-institutional interdisciplinary management. A total of 531 patients admitted during the period were assessed. The overall incidence of delirium was 12% (95% CI, 0.3-14.8). They represented 31.8% of patients in the GU, 15.6% in the ICU, 8.7% in IM, 5.1% in the OU, and 3.9% in the GSU. The most frequent clinical display was the mixed subtype, at 60.9%, followed by the normoactive subtype (34.4%) and the hypoactive subtype (4.7%). The factors most associated with delirium were age (adjusted RR = 1.07; 95% CI, 1.05-1.09), the presence of four or more comorbidities (adjusted RR = 2.04; 95% CI, 1.31-3.20), and being a patient in the ICU (adjusted RR = 2.02; 95% CI, 1.22-3.35). The incidence of delirium is heterogeneous in the different departments of the university hospital. The highest incidence occurred in patients that were admitted to the GU. The mixed subtype was the most frequent one, and the main associated factors were age, the presence of four or more comorbidities, and being an ICU patient.

The impact of COVID-19 pandemic on mental health of adolescents are emerging and require particular attention in settings where challenges like armed conflict, poverty and internal displacement have previously affected their mental wellbeing. This study aimed to determine the prevalence of mental health problems and symptoms of anxiety and depression, probable post-traumatic stress disorder, and resilience capacity in adolescents in a post-armed conflict area in Colombia during the COVID-19 pandemic. A cross-sectional study was conducted with 657 school attending adolescents aged 12 to 18 years old. Mental health information was obtained through screening scales for anxiety (GAD-7), depression (PHQ-8), probable post-traumatic stress disorder (PCL-5) and resilience capacity (CD-RISC-25). The prevalence observed for moderate to severe depression symptoms was 30.0% (CI95%=26.5–33.7) and for moderate to severe anxiety symptoms was 18.9% (CI95%=16.0-22.1). A prevalence of probable post-traumatic stress disorder (PTSD) of 22.3% (CI95%=18.1–27.2) was found. The CD-RISC-25 results for resilience had a median score of 54 [IQR:30]. Our results are in line with emerging evidence that suggests multiple domains of adolescents’ mental wellbeing were negatively impacted by the pandemic, and agree with other studies of regions affected by the armed conflict that show an increase in the prevalence of mental health disorders in young populations. In contrast, our data show lower resilience than other studies of adolescents. These findings call for multidisciplinary actions necessary to respond effectively to the impact of the pandemic on the mental health of adolescents, as well as to guarantee a successful educational recovery, being schools key places in which prompt intervention might reduce the burden of mental distress in adolescents.

Background: Estimating morbidity outcomes and the rate of progression of chronic kidney disease (CKD) patients is of great importance for the health systems. Objective: The objective of this study is to estimate the incidence of dialysis initiation and the rate of CKD progression in 2 years follow-up and identify factors associated with dialysis starts. Methods: A retrospective cohort study of adult with diagnosed CKD stages-G3, G4 (estimated glomerular filtration rate between 60 and 15 ml/min/1.73 m2) enrolled into a CKD prevention program in Bogotá-Colombia, since January 1, 2016, to June 30, 2017, with follow-up until June 30, 2019. Cohort’s outcomes were arrival to dialysis and stage G5, dropout of the program, hospitalization, and mortality. Repeated measurements of the estimation of glomerular filtration rate (eGFR) allowed us to estimate the change over time in 4-month periods using a mixed-effects model. An Extended Cox model was adjusted for the time to start dialysis. Results: One thousand four hundred forty-eight patients were included in the analysis; the incidence rate of dialysis initiation was 2.1 events per 100 patients-year (95% CI: 1.5 2.7). The mean of eGFR variation was +1.1 ml/min/1.73 m2/year; and for diabetics was −1.0 ml/min/m2/year. Being diabetic and having poorly controlled hypertension were significant risk factors for time to dialysis initiation. Conclusion: The incidence rates of dialysis initiation, dropout, and hospitalization are outcomes of significant interest in a CKD prevention program. Being diabetic and poor blood pressure control are risk factors for a more rapid progression to dialysis.

Background Colombia has one of the largest populations of internally displaced individuals by an armed conflict. However, there is no data demonstrating its effect on health, particularly in adolescents. Purpose To describe the prevalence and associations of mental illness in the adolescent population displaced by violence in Colombia. Methods We conducted a secondary analysis of the 2015 National Mental Health Survey (NMHS), which provides data of mental health issues (SRQ), mental health disorders (CIDI-CAPI) and sociodemographic characteristics. Results Of the 1754 adolescents interviewed 5.3% (95% CI 4.1 to 6.9) mentioned a change in residence due to violence. Among them 38.5% lived in poverty compared to 23.6% of those non-displaced by the conflict. Suicidal thoughts and suicide attempt were present in 19.8% and 9.1% of displaced adolescents respectively, compared to 5.8% and 2.1% of non-displaced adolescents. The prevalence of post-traumatic stress disorder (PTSD) and any mental health disorder (measured with the CIDI-CAPI) was higher in the displaced population 12.3%, 11% respectively, in contrast to 2.1% and 7% of those non-displaced. Finally, anxiety and depressive disorders were more common among displaced adolescents. Conclusion A higher prevalence of mental health conditions and disorders is observed among displaced adolescents.

Abstract Background Associations between mental health and dermatology have generated a new branch of study called psychodermatology, which includes relevant conditions to the adolescent population. However, there is limited research focusing on this field and this specific population. Objective To estimate the prevalence of dermatological pathologies in the Colombian adolescent population and their possible associations with mental health conditions. Methods We performed a secondary analysis of the Colombian National Mental Health Survey results. A representative sample of the adolescent Colombian population answered questions regarding dermatological conditions and mental health disorders. We estimated the prevalence and evaluated associations using the chi squared independence test. Results Of 1753 adolescents, 8.3% (CI95%=[6.8–10.1]) had dermatitis or skin allergies and 4.5% (CI95%=[3.3–6.1]) acne. For dermatitis, we found associations with age, education, and family dysfunction (p-Values=0.024; <0.001; 0.046 respectively). Acne was associated with age, sex, educational level, the number of social groups involved in, alcohol consumption, psychoactive substances use and previous violent experiences (respective p-Values=0.007; 0.004; 0.005; 0.036; 0.002; 0.003; 0.044). Regarding mental health, dermatological conditions were associated with depression, affective disorders, suicide attempt and suicide ideation. Conclusion Our results are the first to describe the prevalence of these disorders in Colombia. This is an exploratory study; nonetheless, it is of great value since it is the first to describe these associations in adolescents in a middle-income country, which should be considered during clinical examinations. Further longitudinal studies evaluating possible causal relationship between psychiatric and dermatological conditions are fundamental to establish causal links.

Acute appendicitis is the most common acute surgical abdominal pathology in children, and it has a large impact on morbidity and the costs incurred by health care systems. In low- and median-income countries, national information on the clinical and economic outcomes associated with this surgery does not exist. This study aimed to identify and describe the clinical and economic outcomes for children undergoing appendectomy in Colombia’s contributory system and to determine the prognostic factors associated with these outcomes. A retrospective cohort study was conducted using administrative data from patients under 18 years of age who underwent an appendectomy between July 1, 2013, and September 30, 2015, in Colombia’s contributory health system. Thirty-day mortality rates, intensive care unit (ICU) admission rates, length of stay (LOS), readmission rates and median costs were estimated for the entire country by geographic region and insurer. The prognostic factors associated with these outcomes were identified using generalized multilevel mixed models. A total of 21,674 children were included. The 30-day postoperative mortality rate was 0.06% [95% CI 0.02–0.9], the ICU admission rate was 8.00% [95% CI 7.63–8.36], the mean LOS was 2.48 days (SD 5.24), the readmission rate was 1.5% [95% CI 1.33–1.66] and the median cost for Colombia was 394 USD [p25–p75: 256–555]. The prognostic factors that were associated with the 30-day ICU admission rate, LOS and readmission rate were the insurer, geographic region, age, occurrence of an appendectomy with peritoneal drainage, and certain comorbidities, such as cancer and neurological, respiratory and gastrointestinal illnesses. The prognostic factors associated with costs were those previously mentioned as well as the occurrence of a laparoscopic appendectomy. In Colombia’s contributory health system, large differences in clinical outcomes and the costs incurred by the system exist, and these differences are associated with the geographic region, the insurer, and some of the clinical characteristics of the children undergoing appendectomy.

Introducción: Se ha propuesto una estrecha asociación entre trastornos del afecto y ansiedad en adolescentes con consumo de sustancias. Objetivo: Determinar la prevalencia del consumo de sustancias psicoactivas y los trastornos mentales más frecuentes asociados éste consumo, en adolescentes colombianos. Metodologí­a: Estudio transversal, con datos de la Encuesta Nacional de Salud Mental 2015. Con adolescentes entre 12 y 17 años, en quienes se les aplicó CIDI-CAPI (versión 21.1.3) asistida por computador y Assist modificado. Resultados: Se describió información de 408 adolescentes entre 12 y 17 años que reportan consumo de sustancias psicoactivas por lo menos una vez en la vida, siendo una muestra representativa a nivel nacional. Se encontró que la sustancia de mayor consumo fue el alcohol con una prevalencia de 16,6% (IC95% 14,2-19,2), Bogotá constituye la región con mayor consumo de sustancias con una prevalencia de 33,8% (IC95% 24,7-44,2). Ser hombre entre los 16 y 17 años representa un factor de riesgo para consumo de sustancias, así­ mismo, presentar trastornos del afecto aumenta 2,28 veces el riesgo de consumo de sustancias psicoactivas. Conclusiones: La población adolescente con trastornos del afecto o ansiedad se encuentra en mayor riesgo de consumir sustancias psicoactivas. Introduction: An association between affective and anxiety disorders has been proposed in adolescents with substance use. Objective: To determine the prevalence of psychoactive substance use and the most frequent mental disorders associated with this consumption, in Colombian adolescents. Methods: This is a cross-sectional study that uses data from the National Mental Health Survey 2015. With adolescents between 12 and 17 years old, in whom CIDI-CAPI (version 21.1.3) was applied by computer and modified ASSIST. Results: A total of 408 adolescents between 12 and 17 years old who reported psychoactive substance use at least once in their lives were described , this group was a representative sample of national population. The most frequent consumed substance was alcohol with a prevalence of 16.6% (95% CI, 14.2-19.2), Bogotá is the region with the highest consumption of substances with a prevalence of 33.8% (IC95 % 24.7-44.2). Otherwise, being a man between 16 and 17 years old represents a risk factor for substance use. Likewise, presenting affective disorders increases by 2.28 times the risk of psychoactive substance use. Conclusions: adolescents with affective or anxiety disorders are at higher risk of psychoactive substances use, making difficult the treatment and desmonstrating the vulnerability of this population.Â

Objectives To study socioeconomic inequalities in mental health in rural and urban Colombia, a country with a history of internal conflict and large socioeconomic inequalities. Recent survey data are available to study this understudied topic in a middle-income country. Methods Using data from 9656 respondents from the 2015 Colombian Mental Health survey, we investigated the association between lifetime prevalence of depressive and anxiety disorders and quality of dwellings and access to public services housing score (HS). We calculated the relative index of inequality (RII) and slope index of inequality (SII) for HS in urban and rural areas, adjusting for potential confounders and mediating factors. Outcomes The lifetime prevalence of anxiety and depression (combined) was 9.6% in urban versus 6.9% in rural areas (p<0.001). HS was not associated with prevalence of anxiety and depression in urban settings, whereas a higher HS (poorer housing quality) was associated with fewer mental disorders in rural areas in both univariate and multivariate models (multivariate RIIurban0.96 (95% CI 0.51 to 1.81); RIIrural0.11 (95% CI 0.04 to 0.32)). In rural areas, the prevalence of mental health problems was 12% points lower in persons living in the poorest quality dwellings than in those living in high-quality dwellings (SII −0.12 (95% CI −0.18 to −0.06)). Interestingly, within rural areas, persons living in ‘populated centres’ (small towns, villages) had a higher lifetime prevalence of any mental health disorder (9.8% (95% CI 6.9 to 13.6)) compared with those living in more isolated, dispersed areas (6.0% (95% CI 4.6 to 7.7)). Interpretation In rural Colombia, those living in the poorest houses and in dispersed areas had a lower prevalence of mental health problems. Further understanding of this phenomenon of a seemingly inverse association of prevalence of mental disorders with poverty and/or urbanisation in rural areas is needed. Particularly, considering the progressive urbanisation process in Colombia, it is important to monitor mental health in populations migrating to the cities.

INTRODUCTION:The armed conflict in Colombia is considered one of the most violent in Latin America. Children as a vulnerable population are most affected, increasing their risk of developing mental problems such as anxiety disorder and post-traumatic stress disorder.OBJECTIVES:To determine the prevalence of the most frequent mental problems in the Colombian children affected by armed conflict.METHODOLOGY:A cross-sectional study, using data from the National Mental Health Survey 2015. With children aged 7 to 11 years, in whom the RQC, PCL and DISC-IV-P (3.0.1) were applied.RESULTS:We described information on 100 displaced children between 7 and 11 years old due to armed conflict, being a representative sample at national level. It was found that 98.7% of this population is at school, as well as 17.8% in poverty. Mental illnesses were asked according to their appearance in the last 12 months, these were: anxiety disorder 6.5% (CI 95% 2.7-14.7) in displaced population, compared to 1.8% (CI 95% 1.1-3.1) in non-displaced; High score for post-traumatic stress was 13.2% (CI 95% 3.9-36.4) in displaced persons and 6.6% (CI 95% 4.0-10.7) in nondisplaced persons.CONCLUSIONS:Children affected by armed conflict have greater risk of presenting some mental illnesses such as anxiety disorder and post-traumatic stress, evidencing the situation of vulnerability in which they are.