Adolescent suicide is a public health issue in Latin America, and particularly in Chile. School-based programs have been described as effective mechanisms for suicide prevention. However, less is known about participants’ perceptions during these programs, which is essential for their applicability and adherence. This study investigated the perceptions of students, parents, and teachers regarding the implementation of the RADAR program in a vulnerable school in Puente Alto, Chile. This program aims to prevent suicidal behavior in adolescents by creating a community network that identifies and refers them to specialized care. A codebook TA was used to explore participants lived experiences with the RADAR program. Three focus groups were conducted with students, parents, and teachers at a high-vulnerability school. The information was transcribed, coded, and analyzed using a thematic analysis to identify the program’s perceptions, benefits, and challenges through the lens of CFIR. Teachers, parents, and students had positive perceptions of the RADAR program. Participants valued access to mental health professionals. Teachers and students appreciated that the program fosters open discussion about mental health. However, challenges, including low levels of understanding of mental health and stigma between classmates and families, insufficient communication with teachers about the program, and barriers to specialized care in the public system, were described by participants. This study highlights the need for parental involvement, enhanced communication, mental health education, and effective public policies to improve access to public mental health services. All the findings emphasize the critical importance of adapted suicide prevention programs and foster collaboration between families, educational institutions, and the healthcare system.

Abstract The double burden of diseases and scarce resources in developing countries highlight the need to change conceptualization of health problems and development of translational research. Contrary to the traditional paradigm focused on genetics, the exposome approach proposed in 2005 that complements the genome is an innovative theory. It involves a holistic approach to understanding the complexity of the interactions between the human being’s environment throughout their life and health. Herein, we have describe the conceptual model and technological system development of the Chilean exposome-based system for ecosystems (CHiESS). It is an intelligent and dynamic system for human exposome research, which leverages available administrative data routinely collected by national agencies, in clinical records, and by biobanks. Based on the ecological theory and one-health ecosystem approach, CHiESS considers a multilevel exposure for exposome operationalization, including the ecosystem, community, population, and individual levels. CHiESS will include four consecutive stages for development into an informatic platform: 1) environmental data integration and harmonization system, 2) clinical and omics data integration, 3) advanced analytical algorithm development, and 4) visualization interface development and targeted population-based cohort recruitment. The ChiESS platform aims to integrate and harmonize available secondary administrative data and provide a complete geospatial mapping of the external exposome. Additionally, it aims to analyze complex interactions between environmental stressors of the ecosystem and molecular processes of the human being and their effect on human health. Moreover, by identifying exosome-based hotspots, CHiESS allows the targeted and efficient recruitment of population-based cohorts for translational research and impact evaluation.

The double burden of diseases and scarce resources in developing countries highlight the need to change the conceptualization of health problems and translational research. Contrary to the traditional paradigm focused on genetics, the exposome paradigm proposed in 2005 that complements the genome is an innovative theory. It involves a holistic approach to understanding the complexity of the interactions between the human being’s environment throughout their life and health. This paper outlines a scalable framework for exposome research, integrating diverse data sources for comprehensive public health surveillance and policy support. The Chilean exposome-based system for ecosystems (CHiESS) project proposes a conceptual model based on the ecological and One Health approaches, and the development of a technological dynamic platform for exposome research, which leverages available administrative data routinely collected by national agencies, in clinical records, and by biobanks. CHiESS considers a multilevel exposure for exposome operationalization, including the ecosystem, community, population, and individual levels. CHiESS will include four consecutive stages for development into an informatic platform: (1) environmental data integration and harmonization system, (2) clinical and omics data integration, (3) advanced analytical algorithm development, and (4) visualization interface development and targeted population-based cohort recruitment. The CHiESS platform aims to integrate and harmonize available secondary administrative data and provide a complete geospatial mapping of the external exposome. Additionally, it aims to analyze complex interactions between environmental stressors of the ecosystem and molecular processes of the human being and their effect on human health. Moreover, by identifying exposome-based hotspots, CHiESS allows the targeted and efficient recruitment of population-based cohorts for translational research and impact evaluation. Utilizing advanced technologies such as Artificial Intelligence (AI), Internet of Things (IoT), and blockchain, this framework enhances data security, real-time monitoring, and predictive analytics. The CHiESS model is adaptable for international use, promoting global health collaboration and supporting sustainable development goals.

Background: Major Depressive Disorder (MDD) is a public health problem of increasing severity in Chile. However, prevalence studies of MDD yield discordant results. Reconciling these discordances, at least in part, requires improving the estimate of MDD prevalence in Chile.

Background: Major Depressive Disorder (MDD) is a public health problem of increasing severity in Chile. However, prevalence studies of MDD yield discordant results. Reconciling these discordances, at least in part, requires improving the estimate of MDD prevalence in Chile. Aim: To improve the estimate of MDD prevalence in Chile, by combining data from the 2016/17 Chilean National Health Survey (ENS) with data from the mandatory notifications of users of the Explicit health guaranties (GES acronym in Spanish) program of the Ministry of Health for MDD treatment. Material and Methods: The 2016/17 ENS, applied a Composite International Diagnostic Interview (CIDI) module (n = 3,403), to diagnose individuals with MDD. This article presents an approach that combines the CIDI/ENS diagnoses with GES depression notifications for this period. This dataset combination was applied first to individual macro-zones, then at a national level. Results: The analysis with ENS 2016/17 data only, yields a prevalence of MDD in subjects 18 years or older of 6.19% (95% CI: 4.51-8.43). However, the analysis of the combined data sources yields a prevalence that increases to 6.65% (95% CI: 4.63-8.67). In terms of number of cases, this prevalence increase translates into 63,474 additional MDD cases per year. Conclusions: The MDD prevalence that results from combining ENS 2016/17 and GES data is greater than the prevalence reported by the ENS 2016/17 alone. This increase in cases allows policymakers to improve budgeting and implementation of public policies concerning the prevention and treatment of MDD.

Health-related quality of life (HRQoL) deterioraton is a risk factor for suicide in adults, however, this aspect has been little studied in adolescents.To evaluate the asso ciation between HRQoL (measured with EQ-5D-5L) and suicidal risk in adolescents and its capacity for cross-sectional detection of suicidal risk.128 adolescents (15-19 years old) from Puerto Aysen (Chile) responded to the EQ-5D-5L questionnaire, the Okasha Suicide Scale and two anchoring questions of imminent suicide risk. A suicide risk case was considered to have a > 5 score on the Okasha scale or the affirmative answer to one of the anchoring questions. The index value of EQ-5D-5L was calculated and Odds Ratios (ORs) were estimated with confidence intervals (95% CI), adjusted for confounders. Areas under the ROC curve (AUC-ROC) were calculated to assess the discriminatory performance of EQ-5D-5L.21 (16.4%) adolescents were at suicidal risk. Controlling for confounders, the EQ-5D-5L dimensions associated with suicidal risk were pain/ discomfort (OR: 2.5; 95% CI 1.1-6.1) and anxiety/depression (OR: 2.2; 95% CI 1.3-3.6). The AUC- ROC for both dimensions was 85% (95% CI 0.75-0.91) and 81% for the EQ-5D-5L index value (95% CI 0.72-0.89).HRQoL could be a risk factor for suicide in adolescents and in this way, the EQ-5D-5L could help in searching for high risk and hidden cases of suicidal risk.

Objective: we present the preliminary results of the implementation of RADAR: a community suicide prevention program in adolescents implemented in two high schools in a south region of Chile. Method: In a pilot study, during 2016, we implemented RADAR in two high schools of Puerto Aysen, in in the Region of Aysen of Chile. A total of 409 actors were trained (among students, school teachers, caregivers and health professionals) for the screening and referral of high suicide risk adolescents. Results: Out of a total of 144 students who passed the RADAR screening systems, 29 cases were detected as suicide risk (20%) and 27 of them were opportunely referred to the Emergency Service of the Hospital of Puerto Aysen. In the second RADAR screening campaign, 3 months later, 90% of the cases no longer presented suicide risk. Conclusion: These results show the high proportion of adolescents at risk of suicide who are not visible by the health system and the feasibility of implementing RADAR in the community as an effective suicide prevention intervention.

We present the preliminary results of the implementation of RADAR: a community suicide prevention program in adolescents implemented in two high schools in a south region of Chile.In a pilot study, during 2016, we implemented RADAR in two high schools of Puerto Aysen, in in the Region of Aysen of Chile. A total of 409 actors were trained (among students, school teachers, caregivers and health professionals) for the screening and referral of high suicide risk adolescents.Out of a total of 144 students who passed the RADAR screening systems, 29 cases were detected as suicide risk (20%) and 27 of them were opportunely referred to the Emergency Service of the Hospital of Puerto Aysen. In the second RADAR screening campaign, 3 months later, 90% of the cases no longer presented suicide risk.These results show the high proportion of ado lescents at risk of suicide who are not visible by the health system and the feasibility of implementing RADAR in the community as an effective suicide prevention intervention.

INTRODUCTION Health-related quality of life (HRQoL) deterioraton is a risk factor for suicide in adults, however, this aspect has been little studied in adolescents. OBJECTIVE To evaluate the asso ciation between HRQoL (measured with EQ-5D-5L) and suicidal risk in adolescents and its capacity for cross-sectional detection of suicidal risk. PATIENTS AND METHOD 128 adolescents (15-19 years old) from Puerto Aysen (Chile) responded to the EQ-5D-5L questionnaire, the Okasha Suicide Scale and two anchoring questions of imminent suicide risk. A suicide risk case was considered to have a > 5 score on the Okasha scale or the affirmative answer to one of the anchoring questions. The index value of EQ-5D-5L was calculated and Odds Ratios (ORs) were estimated with confidence intervals (95% CI), adjusted for confounders. Areas under the ROC curve (AUC-ROC) were calculated to assess the discriminatory performance of EQ-5D-5L. RESULTS 21 (16.4%) adolescents were at suicidal risk. Controlling for confounders, the EQ-5D-5L dimensions associated with suicidal risk were pain/ discomfort (OR: 2.5; 95% CI 1.1-6.1) and anxiety/depression (OR: 2.2; 95% CI 1.3-3.6). The AUC- ROC for both dimensions was 85% (95% CI 0.75-0.91) and 81% for the EQ-5D-5L index value (95% CI 0.72-0.89). CONCLUSIONS HRQoL could be a risk factor for suicide in adolescents and in this way, the EQ-5D-5L could help in searching for high risk and hidden cases of suicidal risk.

Más de la mitad de los pacientes con trastorno de personalidad limítrofe (TPL) han realizado al menos un intento suicida durante su vida y el 70% ha tenido al menos una hospitalización psiquiátrica. La presente investigación tiene como objetivo evaluar la efectividad de la Terapia Conductual Dialéctica (TCD) en pacientes con trastorno de personalidad limítrofe.

Introducción: El suicidio es la segunda causa mundial de mortalidad en personas de 15 a 29 años, por ende, su prevención es fundamental. En Chile no existen programas implementados en colegios para capacitar a profesores en la prevención de estas conductas. Se diseñó una capacitación orientada a profesores para conocer si esta estrategia es efectiva en mejorar la autopercepción de competencias al enfrentarse a estas situaciones.

Background: Despite the many studies trying to evaluate the magnitude of suicide in Chile, none of them include the new valid data, recently published by the DEIS of the Chilean Health Ministry. Aim: This paper sought to describe how suicide rates changed among Chileans who were at least 15 years of age during the period of 2001-2010; these rates were stratified by sex, age, urban/rural status, and region of the country. Method: An exploratory and temporal study was conducted. Suicide mortality rates were calculated by collecting information from the Chilean Ministry of Health's death registry between 2001 and 2010 among subjects who were at least 15 years of age. Crude and age-adjusted mortality rates were computed. Results: The standardized suicide rate in Chile during 2001-2010 was 14.7 deaths per 100,000, the highest in South America. The minimum age-adjusted suicide rate observed during the examined period was 13.49 per 100,000 in 2005, and the maximum, 16.67 per 100,000 in 2008. Suicide rates among men were up to 4.8 times the suicide rates among women. In addition, rates in rural areas were double compared with urban areas. Hanging was the most common suicide method, followed by use of firearms and explosives in men and poisoning in women. Finally, there was a progressive increase in suicide rates in the southernmost regions of the country. Conclusion: Suicide rates in Chile are relatively high among male subjects in rural areas. There is a disturbing increase in suicide rates among younger individuals and women, although these rates remain lower among younger individuals and women than among adults in general.

Resumen es: Las muertes por suicidio han aumentado a nivel mundial y especialmente en nuestro pais en la ultima decada. Por ello se hace necesario realizar un trabaj...

Introduccion y objetivosEl trastorno depresivo mayor es uno de los trastornos psiquiátricos más comunes hallados en pacientes con acné. Se estudia la relación entre acné y trastorno depresivo mayor.MétodoEstudio de casos y controles realizado en una clínica dermatológica de Santiago de Chile. Se incluyó en el grupo de casos a todos los pacientes de nuestro centro con diagnóstico de acné realizado por un dermatólogo experto. El grupo control estaba constituido por pacientes sin acné, familiares de los pacientes incluidos en el grupo de casos. Los sujetos incluidos en ambos grupos fueron apareados por edad, sexo y nivel socioeconómico. Para evaluar el caso de trastorno depresivo se aplicó la Entrevista Diagnóstica Internacional Compuesta (CIDI) a ambos grupos. Se comparó todas las variables numéricas con la prueba de la t de Student y las variables categóricas con las pruebas de la χ2 y odds ratio (OR).ResultadosSe obtuvo un total de 60 pacientes (30 en cada grupo), 21 mujeres (70%) y 9 varones (30%). Todos los pacientes completaron el cuestionario. De todas las variables analizadas demográficamente, no hubo diferencias significativas entre ambos grupos. En el grupo de casos, 9 (30%) cumplían los criterios diagnósticos de síndrome depresivo mayor, mientras que sólo 2 (6,6%) los cumplían en el grupo control (OR=6; intervalo de confianza del 95%, 1,03-45,22; p=0,02).ConclusionesSegún este estudio, hay relación estadísticamente significativa entre el trastorno depresivo mayor y el acné, con 6 veces más riesgo para los pacientes que tienen acné.

The attention deficit hyperactivity disorder (ADHD) is the most common diagnosis in child psychiatry, and persists very often in adulthood. These patients have poor lifestyles, especially in affective, work and social areas. Although patients with ADHD have a high rate of comorbidity (e.g. drug and alcohol abuse, depressive and anxiety disorders), this diagnosis is missed by the general physician, deferring its identification and opportune treatment. This article is a review about this disorder and gives tools for its recognition and derivation.