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Browsing by Author "Florenzano, Ramón"

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A Multi-Country Study of Harms to Children Because of Others’ Drinking
(2017) Laslett, Anne-Marie; Rankin, Georgia; Waleewong, Orratai; Callinan, Sarah; Hoangs, Hanh T. M.; Florenzano, Ramón; Hettige, Siri; Obot, Isidore; Siengsounthone, Latsamy; Ibanga, Akanidomo; Hope, Ann; Vu, Hanh T. M.; Thamarangsi, Thaksaphon; Rekve, Dag; Room, Robin
Objective: This study aims to ascertain and compare the prevalence and correlates of alcohol-related harms to children cross-nationally. Method: National and regional sample surveys of randomly selected households included 7,848 carers (4,223 women) from eight countries (Australia, Chile, Ireland, Lao People’s Democratic Republic [PDR], Nigeria, Sri Lanka, Thailand, and Vietnam). Country response rates ranged from 35% to 99%. Face-to-face or telephone surveys asking about harm from others’ drinking to children ages 0–17 years were conducted, including four specific harms: that because of others’ drinking in the past year children had been (a) physically hurt, (b) verbally abused, (c) exposed to domestic violence, or (d) left unsupervised. Results: The prevalence of alcohol-related harms to children varied from a low of 4% in Lao PDR to 14% in Vietnam. Alcohol-related harms to children were reported by a substantial minority of families in most countries, with only Lao PDR and Nigeria reporting significantly lower levels of harm. Alcohol-related harms to children were dispersed sociodemographically and were concentrated in families with heavy drinkers. Conclusions: Family-level drinking patterns were consistently identified as correlates of harm to children because of others’ drinking, whereas sociodemographic factors showed few obvious correlations.
Adaptación de escala que evalúa ideación suicida en alumnos adolescentes de educación especial
(Universidad del Desarrollo. Facultad de Psicología, 2017) Cortés Fritz, Fernando Gabriel; Florenzano, Ramón
Alcohol’s harm to others: An international collaborative project
(2016) Callinan, Sarah; Laslett, Anne-Marie; Rekve, Dag; Room, Robin; Waleewong, Orratai; Benegal, Vivek; Huckle, Taisia; Florenzano, Ramón; Casswell, Sally; Hanh, Hoang Thi My; Hettige, Siri; Ibanga, Akanidomo; Obot, Isidore; Rao, Girish; Siengsounthone, Latsamy; Ranki, Georgia; Thamarangsi, Thaksaphon
Abstract Aims: This paper outlines the methods of a collaborative population survey project measuring the range and magnitude of alcohol’s harm to others internationally. Setting: Seven countries participating in the World Health Organization (WHO) and ThaiHealth Promotion Foundation (ThaiHealth) research project titled “The Harm to Others from Drinking,” along with two other countries with similar studies, will form the core of a database which will incorporate data from other countries in the future. Measures: The WHO-ThaiHealth research project developed two comparable versions of a survey instrument, both measuring harm from others’ drinking to the respondent and the respondent’s children. Design: Surveys were administered via face-to-face methods in seven countries, while similar surveys were administered via computer-assisted telephone interviews in two additional countries. Responses from all surveys will be compiled in an international database for the purpose of international comparisons. Discussion: Harms from the alcohol consumption of others are intertwined with the cultural norms where consumption occurs. The development of this database will make it possible to look beyond reports and analyses at national levels, and illuminate the relationships between consumption, harms, and culture. Conclusions: This database will facilitate work describing the prevalence, patterning, and predictors of personal reports of harm from others’ drinking cross-nationally.
Alcohol’s impact on children and families. A population survey
(2016) Florenzano, Ramón; Echeverría, Angela; Sieverson, Catalina; Barr, Michelle; Fernández, Miguel
Introduction: Alcohol is widely used among young families, and leisure time is frequently family time. Heavy alcohol consumption can adversely affect children. The objective of this work is to measure the harm to others in Chile. Subjects and method: This descriptive and probabilistic study forms part of a collaborative research funded by Thai Health and WHO. The survey was adapted by co-researchers and applied to a nationally representative sample of 1500 Chileans over 18 years of age. Results: A total of 408 respondents (27.2%) lived with children at home. Of this total, 10.5% felt that the use of alcohol by any member of the family had adversely affected a child. The most common adverse effects were verbal violence (29.7%), domestic violence (23.1%), unsupervised homes (18.7%), lack of money to provide basic needs of the child (14.3%), and physical violence (7.7%). Furthermore, in 6.6% of the cases child or family services agencies became involved. In almost half of the cases (46.3%), the drinker was the father, mother or step-parents. This was followed by other relatives (24.4%) and brothers (4.9%), or guardian of the child (2.4%). Conclusion: These data support the clinical observation that alcohol is common in Chilean homes. Its consumption not only damages the physical and mental health of the drinker but also those around him. Verbal violence and witnessing serious physical violence are frequent issues, as well as economic problems that end up with the inability to provide the child with its basic needs. (C) 2016 Published by Elsevier Espana, S. L. U. on behalf of Sociedad Chilena de Pediatria.
Un análisis bibliométrico de los trabajos libres de psiquiatría presentados a congresos de la Sociedad Chilena de Neurología, Psiquiatría y Neurocirugía entre 2000 y 2009
(2011) San Juan B, Katherine; Villena C, Carolina; Taha G, Nicole; Fogar F, Andrés; Florenzano, Ramón
Introducción: La bibliometría es la disciplina que mide la producción bibliográfica en un área científica determinada y en Chile hay pocos estudios que documenten los temas y tendencias de la producción en Salud Mental. Método: Se hace un análisis cuantitativo de los 992 trabajos publicados en los libros de resúmenes de los Congresos entre los años 2000y 2009. Se describen los grupos más productivos, así como se clasifican los temas de acuerdo a los títulos de los trabajos, al índice del Tratado de Psiquiatría editado por Heerlein y Cols. Resultados: Los temas más frecuentes eran los del trastornos del ánimo (14,3%), psiquiatría de enlace y hospital general (8,6%), epidemiología y clasificación (6,6%), validación y aplicación de instrumentos diagnósticos y de medición psicológica (5,6%), y los menos frecuentes antidepresivos y docencia con 1,2% cada uno. La mayoría de las presentaciones correspondieron a centros universitarios (48%) u hospitalarios (35%), con una importante concentración en la Región Metropolitana (80,4%) y la VIII Región (8,3%). Conclusiones: Se observa un número creciente de presentaciones desde el año 2000 hasta el 2009, siendo la RM quien presenta el mayor número de investigaciones con un 76,31%, llama la atención la baja asociatividad en las presentaciones: un 88,3% de los trabajos fueron presentados por una sola institucion. 9,6% (o sea 59 trabajos) fueron presentados por dos, y 2,1% (13 trabajos) por tres instituciones.Los trastornos del ánimo son el sub-tema más analizado, seguido por antipsicóticos y psiquiatría de enlace, comunitaria e infanto-juvenil.
Análisis retrospectivo de las creencias religiosas en mujeres con trastorno afectivo tratadas ambulatoriamente por riesgo suicida en un servicio de psiquiatría en Santiago de Chile
(2015) Florenzano, Ramón; Aspillaga H., Carolina; Alliende, Lucia; Cataldo, Eny; Aratto, Claudia
Socio-demographic and clinical characteristics are compared among women with affective disorder diagnosis and suicidality, treated in the Psychiatry Service of the Hospital del Salvador (SPHDS) in Santiago de Chile. The database of the SPHDS about women treated as outpatients between 2003 and 2010, was analyzed (n=214), comparing religious affiliation, suicidal risk type, affective disorder diagnoses, comorbidity with personality disorder and OQ 45.2 score. Non-believers treated patients were younger (M=38) than believers (M=39,36) They didn't differ in other sociodemographic or clinical characteristics, neither in presence or absence of suicidal ideation or attempts. The main difference found among women with affective disorder and suicidal risk was the greater severity of the clinical condition among the outpatient non-believers.
Daño a niños y sus familias por el consumo de alcohol: resultados de una encuesta poblacional
(2016) Florenzano, Ramón; Echeverría, Angela; Barr, Michelle; Fernández, Miguel Angel
Introducción Entre los adultos jóvenes el uso de alcohol es frecuente. Este consumo puede afectar negativamente a los menores que conviven con ellos, lo que constituye el objetivo de este estudio, que forma parte de un estudio colaborativo internacional financiado por Thai Health y la OMS. Sujetos y método Se describen los efectos negativos en niños, mediante un muestreo multietápico, aplicando una entrevista adaptada por los coinvestigadores a 1.500 chilenos de más de 18 años. Resultados Un total de 408 encuestados (27,2%) convivían con niños en el hogar. De ese total, el 10,5% estimó que el uso de alcohol de algún miembro de la familia había afectado negativamente a un niño. Los efectos más comunes fueron la violencia verbal (29,7%), presenciar violencia en el hogar (23,1%), ausencia de supervisión (18,7%), falta de dinero para proveer necesidades básicas (14,3%) y violencia física (7,7%). Casi en la mitad de los casos (46,3%) el bebedor era el padre o la madre, el padrastro/madrastra, o la pareja de la madre/padre, luego venían otros parientes (24,4%), un hermano/a del niño (4,9%) o un tutor del niño (2,4%). Conclusión Estos datos corroboran la observación clínica de que el consumo de alcohol es frecuente en los hogares. El consumo excesivo daña la salud física y mental no solo del bebedor sino también de quienes lo rodean. La violencia verbal y ser testigo de violencia grave en el hogar son frecuentes, así como los problemas económicos al no poder proveer sus necesidades básicas.
Eficacia y costos asociados a un tratamiento ambulatorio en mujeres con depresión severa y trauma temprano
(2010) Florenzano, Ramón; VITRIOL G, VERÓNICA; CANCINO A, ALFREDO; BALLESTEROS T, SOLEDAD; SCHWARTZ P., DANIEL
A high proportion of women consulting for depression have a history of childhood abuse and trauma. Aim: To compare the effcacy and costs associated with a treatment that inquires directly into childhood trauma and understands present interpersonal diffculties as a compulsion to repeat the traumatic past, versus the usual treatment, in women with severe depression and childhood trauma. Material and Methods: Eighty seven women with depression and prior history of early trauma that sought help at the Mental Health Unit of the Hospital de Curicó were studied. Forty four were randomly assigned to the experimental treatment, and 43 to the usual management. Patients were evaluated using the Hamilton Depression Scale, the Outcome Questionnaire (OQ 45.2) and an expenditures sheet at baseline, three and six months. An intention to treat analysis and a simple cost-analysis were performed.
La espiritualidad y religiosidad como factor protector en mujeres depresivas con riesgo suicida: consenso de expertos
(2011) Taha, Nicole; Florenzano, Ramón; Sieverson, Catalina; Aspillaga H., Carolina; Alliende, Lucía
This document presents the expert consensus produced by a working meeting in Santiago de Chile during 2010 about “The Spirituality and Religiosity as a protective factor in depressive women with Suicidal Risk”. The consensus followed the steps suggested by Delphi methodology. Its results are organized in five areas referent to spiritual/religious interventions: a) setting, b) counselor training, c) elements, d) subjects covered, e) stages. The experts consulted concluded that spiritual and religious aspects need to be considerate in each case, and that in believers can improve progress and prevent relapses at suicidal risk. However in some cases religious can increase the amounts of fault, amplifying the severity and complicating the evolution.
Evaluación Naturalística del Efecto de Terapias Psicoanalíticamente Orientadas y Terapias Cognitivas en un Hospital General Público en Santiago de Chile1
(2010) Florenzano, Ramón; Leiva, Pamela; Riquelme, Raúl; Möller, Francisca; Calderón, Ana
En Chile existen pocos estudios comparativos sobre la efectividad y eficiencia de las psicoterapias psicoanalíticas, por lo que aquí revisamos resultados de la aplicación rutinaria del OQ 45.2 de Lambert et. al. en un servicio de psiquiatría pública en Santiago. Encontramos descensos de puntajes globales y de las subescalas desde el pre-test (M1) hasta los post-test precoz (M2) y tardío (M3). Este descenso fue mayor en la Unidad de Trastornos de Personalidad UTP (n=37), de orientación psicoanalítica, que en la de Terapia Cognitiva (n=37). Si bien en ambas hubo cambio clínicamente significativo en la primera el descenso fue mayor. El principal problema en ambos grupos fue la adherencia. En esta comparación encontramos buena efectividad y eficiencia de terapias psicoanalíticas en un servicio público en Chile.
Freud, Jung y la Competencia Maestro-Discipulo
(2016) Florenzano, Ramón; Igor, Sophia
Este trabajo revisa la ruptura de la relación profesional y personal de Sigmund Freud y Carl Jung, relacionándola con las etapas de los ciclos vitales de ambos, asi como con la historia del movimiento psicoanalítico y el contexto de la Europa de pre-guerra. Esos fueron años de reconocimiento público de la obra de Freud, durante un periodo que representó un punto de inflexión en la historia del resto del siglo. Se revisan las diferentes hipótesis acerca de esta ruptura: diferencias teóricas; el rol de Sabina Spielrein; las consecuencias del viaje a Estados Unidos de 1911, y sus divergencias con respecto a la psicología de las religiones. Se ilustra finalmente la diferencia de edades entre un maestro activo intelectualmente y un discípulo ambicioso y enérgico con la relación en Chile de Ignacio Matte con Arturo Prat.
Harm to others from alcohol: the role of socio-cultural variables
(2016) Florenzano, Ramón; Huepe, Gabriela; Barr, Michelle
This paper describes the changes in alcohol research, from a traditional individual focus on individual bodily and mental effects, to a broader focus on harm to others. This shift has coincided with broader sequential definitions of the progression from normal through harmful alcohol dependence, both in the specialized epidemiological and also in the newer classificatory systems (DSM 5 and CIE 11 draft). After presenting updated global, regional and chilean data, an international collaborative Project (Alcohol Harm to Others, ATOH) is described, with the participating institutions: the local study and the chilean components of the research team, the conceptual framework of harm to others (families, children, women; neighbors, friends, co-workers; society at large). Ethical aspects and institutional approval are presented and the principal results outlined: socio-demographic data (with special focus on the role of gender, socio-economic level and religiosity/spirituality). The data is presented for the chilean sample, with examples from other participating countries. The complexity of the link between alcohol harm to others and religious and spiritual factors is studied comparing data from several of the participating countries, and the impact upon vulnerable populations, especially women and children. The discussion reviews some of the confounding and intervening factors that could influence the results. The conclusion about prevention and policy development closes the paper.
Harm to others from alcohol: The role of socio-cultural variables
(2016) Florenzano, Ramón; Huepe, Gabriela; Barr, Michelle
This paper describes the changes in alcohol research, from a traditional individual focus on individual bodily and mental effects, to a broader focus on harm to others. This shift has coincided with broader sequential definitions of the progression from normal through harmful alcohol dependence, both in the specialized epidemiological and also in the newer classificatory systems (DSM 5 and CIE 11 draft). After presenting updated global, regional and chilean data, an international collaborative Project (Alcohol Harm to Others, ATOH) is described, with the participating institutions: the local study and the chilean components of the research team, the conceptual framework of harm to others (families, children, women; neighbors, friends, co-workers; society at large). Ethical aspects and institutional approval are presented and the principal results outlined: socio-demographic data (with special focus on the role of gender, socio-economic level and religiosity/spirituality). The data is presented for the chilean sample, with examples from other participating countries. The complexity of the link between alcohol harm to others and religious and spiritual factors is studied comparing data from several of the participating countries, and the impact upon vulnerable populations, especially women and children. The discussion reviews some of the confounding and intervening factors that could influence the results. The conclusion about prevention and policy development closes the paper.
Metodología cualitativa y análisis narrativo en psicoterapia e investigación: una revisión selectiva de la literatura
(2016) Dörr, Anneliese; Florenzano, Ramón; Soto-Aguilar, Francisca; Hammann, Francois; Lira, Teresita
El método narrativo, tan en boga en la actualidad, y que consiste en analizar y describir los datos en forma de relato, ha cobrado especial relevancia tanto para la investigación como para la clínica en salud mental. Sin embargo dicho método es visto de manera confusa por muchos especialistas. Se intenta ordenar el tema desde una perspectiva histórica, revisando selectivamente a autores líderes en el tema, tales como Linseth, Lieblich, Riesman y MacAdams. Para ello se hace un repaso del método y su empleo en la clínica e investigación. Por último, se revisan los usos del método narrativo en psiquiatría, separando aquellos centrados en la entrevista clínica o en intervenciones terapéuticas, de aquellos enfocados en la investigación.
Programas de prevención del suicidio adolescente en establecimientos escolares. una revisión de la literatura
(2013) Bustamante, Francisco; Florenzano, Ramón
Las muertes por suicidio han aumentado a nivel mundial y especialmente en nuestro país en la última década. Por ello se hace necesario realizar un trabajo preventivo, principalmente en adolescentes. El presente trabajo tuvo como objetivo realizar una revisión de la literatura de los programas de prevención de suicidio en adolescentes escolares. Los resultados demostraron que son pocos los programas centrados en abordar el suicidio como objetivo principal sino que su foco son factores asociados, como por ejemplo la depresión mayor. Aún así, varios consiguen una disminución de la ideación y conducta suicida en la población estudiada, especialmente cuando implementan más de una intervención.
Protocolo de manejo del intento suicida en el Hospital del Salvador en Santiago de Chile
(2012) Cárdenas, Juan Pablo; Santelices, Diego; Fredes, Arturo; Florenzano, Ramón
Suicide is a global public health and social problem. It has important emotional consequences for the relatives of the deceased, as well as economic and emotional consequences for the rest of the community. Herein lies the importance of the early detection of potential cases and of utilizing adequate interventions. The present protocol was organized as a way of standardizing and giving the appropriate hierarchy to all interventions practiced in patients with suicidal risk within Hospital del Salvador
¿Qué elementos se incorporan en las evaluaciones de la espiritualidad y religiosidad? Una revisión de instrumentos validados
(2016) Sieverson, Catalina; Evans, Vanessa; Florenzano, Ramón; Fernández, Loreto
Numerosas investigaciones han descrito la relación entre elementos espirituales y religiosos y salud mental, como también la necesidad de incluirlos en la práctica clínica. Sin embargo, las comprensiones de espiritualidad y religiosidad han variado durante las últimas décadas y así también sus formas de evaluación. En este artículo se presenta una revisión de la literatura disponible acerca de instrumentos para evaluar elementos espirituales y religiosos en población general y clínica. La búsqueda se realizó por medio de metabuscadores, según los criterios de inclusión y exclusión planteados por Monod et al. (2011) en una revisión similar. Resultados. 23 instrumentos cumplieron con los criterios requeridos, 10 de los cuales fueron diseñados para población general y 13 para poblaciones clínicas o grupos específicos. El número de instrumentos existentes ha aumentado en los últimos años, todos están disponibles en inglés y fueron diseñados para poblaciones adultas. No se encontraron escalas validadas en español, ni para población chilena en los últimos 20 años. Existen más instrumentos que evalúan la espiritualidad por sobre la religiosidad y, además, se evidencia una estrecha relación entre los conceptos de espiritualidad y bienestar subjetivo. Conclusiones. El interés por evaluar e investigar los elementos ER y su relación con la salud y el bienestar general por medio de instrumentos estandarizados mantiene plena vigencia. Sin embargo, las concepciones de espiritualidad y religiosidad, y su relación con el bienestar general, se han ido estrechando, hecho que se evidencia en las formas de evaluación desarrolladas más recientemente.
Relación entre ideación suicida y estilos parentales en un grupo de adolescentes chilenos
(2011) Florenzano, Ramón; Valdés C., Macarena; Cáceres C., Eugenio; Santander R., Sylvia; Aspillaga H., Carolina; Musalem A., Claudia
Background: In Chile, there has been an increase in suicide rates from 1.1 to 2.6 per 100,000 among adolescents aged 10 to 14 years and from 4.4 to 8.9 per 100,000 among those aged 15 to 19 years Aim: To identify protective factors for suicidal ideation according to parenting styles, as described by Barber et al. Material and Methods: The relation between suicidal ideation and parenting styles was assessed in a random sample of 2,346 Chilean school attending adolescents aged 13 to 20 years old (59% women) from three cities: Antofagasta (Northern Chile, II Region), Santiago (Central, Metropolitan Region) and Concepcion (Southern, VIII Region). Participants were tested with the Chilean adaptation of the Cross National Adolescents Program (CNAP) Plus questionnaire developed by Barber et al. The relation between suicidal ideation and parenting styles was assessed using regression analyses. Results: Correlations between suicidal ideation and parenting styles were mostly significant, yet weak. High odds ratios were observed among parents who had a strong psychological control, inconsistent control, lack of expression of affection and covered marital hostility. Conclusions: High adolescent self-esteem, a good relationship with parents, psychological parental autonomy, expression of physical affection, social support and paternal monitoring were protective factors against suicidal ideation. (Rev Med Chile 2011; 139: 1529-1533).
Scoping response system management of alcohol's harm to others in lower middle income countries
(2016) Laslett, Anne-Marie Louise; Waleewong, Orratai; Obot, Isidore; Benegal, Vivek; Hettige, Siri; Florenzano, Ramón; Hoang Thi My Hanh; Rao, Girish N.; Room, Robin
AIMS - As part of the WHO Harm from others' drinking project, Thailand, Sri Lanka, India, Chile, Nigeria and Vietnam undertook scoping studies to examine: which service agencies in low and middle income countries responded to people affected by others' drinking; how commonly key informants from these agencies indicated alcohol was part of the problems they managed; and whether any routine reporting systems collected information on alcohol's harm to others (AHTO) and the types and examples of harms experienced across the six countries. METHODS - Researchers synthetised within country peer-review literature, reports, news and agency website information. Additionally, researchers interviewed key informants to investigate current structures, functions and practices of service agencies, and in particular their recording practices surrounding cases involving others' drinking. RESULTS - 111 key informants agreed to participate from 91 purposively selected agencies from health, social protection, justice and police, and 'other' sectors. National and provincial level data, as well as state-run and civil society agency data were collected. Diverse service response systems managed AHTO in the different countries. A large range in the percentage of all cases attributed to AHTO was identified. Case story examples from each country illustrate the different responses to, and the nature of, many severe problems experienced because of others' drinking. CONCLUSIONS - AHTO was a major issue for service systems in LMIC, and significantly contributed to their workload, yet, very few recording systems routinely collected AHTO data. Recommendations are outlined to improve AHTO data collection across multiple sectors and enable LMIC to better identify and respond to AHTO.
Suicidal risk, depression, and religiosity: A study of women in a general hospital in Santiago de Chile
(2014) Florenzano, Ramón; Rodríguez T., Jorge; Sieverson, Catalina; Cataldo, Eny; Pastorino, Sol; Fernández, Loreto
The purpose of the present study is to compare the role of spiritual and religious beliefs in the prevention of suicidal risk among depressive women with suicidal ideation or attempts, treated in the psychiatric unit of a general hospital in Santiago de Chile (Servicio de Psiquiatría del Hospital del Salvador) between 2010 and 2011. The relationship among severity of depression, suicidal risk, and religiosity is explored in women treated in Servicio de Psiquiatría del Hospital del Salvador. The sociodemographic and clinical characteristics of believers (n = 121) and nonbelievers (n = 22) were compared, and their global mental health was assessed, as well as their rating in scales for depression, anxiety, aggressivity, and impulsivity. Most of the patients self-reported to belong to Catholic or other Christian churches. There were few statistically significant differences between them and nonbelievers, who were younger, had more years of education, were more frequently employed, and lived alone or with their parents. When comparing the least religious and the most religious quartiles, there were no differences in the type of affective disorder, attendance to temples, or self-appraisal of religiosity. Nonbelievers had more history of previous suicidal attempts and had more relatives committing suicide. In a country where most of the population is believer, self-reported religiosity seems to have a nonsignificant association with suicidality and severity of depression. Our results could be biased given the small number of nonbelievers in the sample.

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