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Objectives: To determine attention performance of medical students after sleep deprivation due to night shift work. Methods: Prospective cohort design. All seventh, eighth and ninth semester students were invited to participate (n= 209). The effectiveness and concentration indices (d2 Test for attention, dependent variable) from 180 students at 3 evaluations during the semester were compared. Eighth and ninth semester students underwent their second evaluation after a night shift. The independent variables were nocturnal sleep measurements. Results: No differences in nocturnal sleep hours during the previous week (p=0.966), sleep deprivation (p=0.703) or effectiveness in the d2 Test (p=0.428) were found between the groups at the beginning of the semester. At the beginning and the end of the semester, the d2 Test results were not different between groups (p=0.410, p=0.394) respectively. The second evaluation showed greater sleep deprivation in students with night shift work (p

Introducción. El polimorfismo 5-HTT se ha asociado con el trastorno de depresión mayor, aunque el planteamiento ha generado controversia.Objetivo. Determinar la asociación del polimorfismo 5-HTT con la depresión mayor en Bogotá, Colombia.Materiales y métodos. Se hizo un estudio de casos y controles pareado por sexo y edad (±5 años), con una razón de uno a uno (68:68). El trastorno de depresión mayor se diagnosticó con el cuestionario Mini-International Neuropsychiatric Interview, y, el polimorfismo 5-HTT, mediante reacción en cadena de la polimerasa (PCR).Resultados. Las mujeres predominaron entre los participantes (82,4 %). El alelo corto (short, S) predominó en los casos comparados con los controles (S: 72,1 % Vs. 63,2; L (long): 27,9 % Vs. 36,8 %), y el genotipo SL fue más frecuente en los casos (SL: 45,6 % Vs. 36,8 %; LL: 27,9 % Vs. 36,8 %; SS: 26,5 % Vs. 26,5 %), aunque no significativamente. Hubo diferencias significativas en menores de 37 años, con predominio del alelo S en los casos (p=0,0384; odds ratio - OR=2,75; IC95%: 0,88-8,64). El análisis multivariado ajustado por trastornos concomitantes de ansiedad mostró una asociación significativa de la depresión mayor con el genotipo SL (p=0,049; OR=3,20; IC95% 1,003-10,233); el alelo S estuvo cerca de la significación estadística (p=0,063; OR=2,94; IC95% 0,94-9,13), y fue estadísticamente significativo en los casos de menores de 37 años (p=0,026; OR=10,79; IC95% 1,32-80,36).Conclusiones. El genotipo SL se asoció con el trastorno de depresión mayor en pacientes de todas las edades. El alelo S se asoció significativamente con el trastorno de depresión mayor en pacientes menores de 37 años al ajustar por trastornos concomitantes de ansiedad.

Objective: to evaluate, with a preliminarystudy, the distribution of circadian rhythms, sleepschedule patterns and their relationship withacademic performance on medical students.Methodology: in this descriptive study, a 10 itemoriginal questionnaire about sleep rhythms andacademic performance was applied to medicalstudents from different semesters. Week (classtime) and weekend schedules, preferences,daytime somnolence and academic performancewere asked. Three chronotypes (morningness,intermediate and eveningness) were definedamong waking-sleeping preference, difficulty tosleep early, exam preparation preference hour and real sleep schedule. The sleep hour deficit perweek night was also calculated. Results: Of the318 medical students that answered the questionnaire,62.6% corresponded to intermediatechronotypes, 8.8% to evening-type and 28.7%to morning-type. Significant difference wasfound among the two chronotype tails (p=0.000,Chi-square 31.13). No correlation was foundbetween academic performance and age, sex,chronotype, week sleep deficit and sleep hours inweek and weekends. A 71.1% of the students slept6 or fewer hours during class time and 78% hada sleep deficit (more frequent in the eveningchronotype). Conclusions: No relation was foundbetween sleep chronotype and academic performance.Students tend to morningness. Fewstudies have been made on equatorial zones orwithout seasons.

Objetivos Determinar en tres municipios de Cundinamarca la prevalencia del Trastorno por Estrés Postraumático (TEPT) infantil y factores asociados, según tipo de exposición a la guerra. Métodos Estudio de corte transversal. Muestra representativa de 493 escolares de 5 a 14 años de edad. 167 niños en La Palma, con exposición crónica; 164 en Arbeláez, con un hostigamiento armado reciente y 162 en Sopó, sin exposición. Por medio de entrevistas psiquiátricas semi-estructuradas y la Escala para Trastorno de Estrés Postraumático Administrada por el Clínico se determinó la prevalencia de TEPT y factores de vulnerabilidad, la razón de desventaja (RD) y Ji-cuadrada. Se hizo análisis multivariado con regresión logística. Los niños afectados requirieron intervención de salud mental. Resultados Prevalencia de TEPT bélico: La Palma 16,8 %, Arbeláez 23,2 %, y Sopó 1,2 %. Al comparar los municipios expuestos con Sopó: RD 19,9 (IC 4,7, 119,2), Ji-cuadrada 30,4 P=0,000. La regresión logística identificó que la proximidad geográfica y la alteración emocional intensa con el evento estresante incrementaron el TEPT. Los factores de vulnerabilidad predominaron en los municipios expuestos a la guerra. Los indicadores de pobreza, baja escolaridad paterna y maltrato infantil predominaron en La Palma. En Arbeláez predominó el déficit de atención y los trastornos psicosomáticos. Conclusiones La Guerra afecta la salud mental infantil. Los niños de los municipios expuestos tuvieron 19 veces mayor probabilidad de sufrir TEPT bélico que los no expuestos. Intervenir tempranamente es prioridad en salud pública. Los resultados son útiles para países con conflicto bélico o terrorismo. OBJECTIVE: Determining the prevalence of post-traumatic stress disorder (PTSD) related to the type of war exposure and associated factors in school-aged children from three Colombian towns. METHODS: Cross-sectional epidemiological study. Representative randomised sample of 493 children aged 5-14. The children were evaluated during 2002 using semi-structured psychiatric interviews and the clinician administered PTSD scale. 167 children were evaluated in La Palma who had been chronically exposed to war, 164 in Arbeláez who had had recent war-exposure and 162 in Sopó who had not been exposed to war. War-related PTSD prevalence was calculated in each municipality. Odds ratio (OR) and chi-square were used for evaluating the association between exposure to war and PTSD and the related risk. Multivariate analysis used the logistic regression model. The affected children required specialised mental health counselling. RESULTS: The prevalence of PTSD resulting from war was 16,8 % in La Palma, 23,2 % in Arbeláez and 1.2% in Sopó. A 19.9 OR (CI 4.7, 119.2), 30,5 Chi-square and p = 0.000 revealed war-related PTSD association and risk for children when comparing the exposed towns to Sopó. The logistic regression showed that geographical closeness to war zone and intense emotional reaction to war increased the probability of war-related PTSD. Vulnerability factors were predominant in war-exposed towns. Poverty, parents' low educational level and child abuse predominated in La Palma. Attention-deficit and psychosomatic disorders were more prevalent in Arbeláez. CONCLUSIONS: War affects children's mental health; the children from the exposed towns had 19 times greater probability of war-related PTSD than those from a non-exposed town. Early therapeutic intervention is a public health priority. The results are useful for countries suffering from war, internal conflict and/or terrorism.

Characterising patients attempting suicide who were evaluated by psychiatry at the Primary Care Unit (PCU) "La Estrella" from October/2004 to October/2005 and determining persistent suicidal ideation and associated factors.An initial description of attempted suicide patients (n=156). A subsequent case control study (n=77) determined persistent suicidal ideation cases (n=27). A multivariate model was used for determining the remaining factors associated with persistent suicide ideation.Cases increased from 6 in October/2004 to 10 in October/2005, average 12+/-3.6 cases monthly. 80% were aged 30 or younger, 66.7% were female, 24.4% were students and 20.5% were unemployed. 35.2% suffered family dysfunction and 35.2% had conflicts between couples as precipitant factors. 49% had consumed alcohol prior to the suicide attempt. Persistent suicidal ideation was associated with being 31 years old or older, being unemployed and having a higher number of previous suicide attempts, unresolved conflicts and family dysfunction. Logistical regression revealed unresolved conflicts (OR=106.7; 6.8; 1,668.4 95% CI) and family dysfunction (OR=11.05; 1.7; 71.2 95% CI) as predictor variables for persistent suicidal ideation.Unresolved conflicts and family dysfunction were found to be predictor factors for persistent suicidal ideation in subjects who had attempted suicide. Consuming alcohol and other associated factors should be controlled by mental health prevention and promotion programmes.

Determining the prevalence of post-traumatic stress disorder (PTSD) related to the type of war exposure and associated factors in school-aged children from three Colombian towns.Cross-sectional epidemiological study. Representative randomised sample of 493 children aged 5-14. The children were evaluated during 2002 using semi-structured psychiatric interviews and the clinician administered PTSD scale. 167 children were evaluated in La Palma who had been chronically exposed to war, 164 in Arbeláez who had had recent war-exposure and 162 in Sopó who had not been exposed to war. War-related PTSD prevalence was calculated in each municipality. Odds ratio (OR) and chi-square were used for evaluating the association between exposure to war and PTSD and the related risk. Multivariate analysis used the logistic regression model. The affected children required specialised mental health counselling.The prevalence of PTSD resulting from war was 16,8 % in La Palma, 23,2 % in Arbeláez and 1.2% in Sopó. A 19.9 OR (CI 4.7, 119.2), 30,5 Chi-square and p = 0.000 revealed war-related PTSD association and risk for children when comparing the exposed towns to Sopó. The logistic regression showed that geographical closeness to war zone and intense emotional reaction to war increased the probability of war-related PTSD. Vulnerability factors were predominant in war-exposed towns. Poverty, parents' low educational level and child abuse predominated in La Palma. Attention-deficit and psychosomatic disorders were more prevalent in Arbeláez.War affects children's mental health; the children from the exposed towns had 19 times greater probability of war-related PTSD than those from a non-exposed town. Early therapeutic intervention is a public health priority. The results are useful for countries suffering from war, internal conflict and/or terrorism.

To evaluate the impact that a violent and a non-violent movie may cause on scholars.In Bogotá, 125 public primary school students were surveyed, applying a questionnaire to learn both about their daily life violence and their attitude towards it. Two weeks later, they were shown one violent movie, and two weeks later a non-violent one. Children were asked to draw their families, express their opinions and answer a questionnaire after each movie.The initial survey showed that 23.6% of the children reported violent responses when they were offended, 39.8% reported some kind of familiar violence and 19.5% identified themselves with a violent figure. Boys were more prone to respond violently when offended and to identify themselves with a violent figure than girls (p=0.004). Compared with the non-violent movie, a greater percentage of children excluded themselves from the family drawing after watching the violent movie (Odds Ratio (OR): 2.55; 95% Interval Confidence (95% CI) 1.22-5.43, p=0.01). The family drawing after the violent movie also showed more emotional signs (OR: 3.13; 95% CI: 1.35-7.52; p=0.0053) and more aggressive signs (OR: 2.55; 95% CI: 1.22-5.43; p=0.01) than the family drawing after the non-violent movie.The family drawing test showed the immediate impact of television. Television violence negatively influences kids and should be avoided.

Objetivos Conocer el impacto en niños escolares ocasionado por una película violenta y otra no violenta. Métodos En una escuela pública de Bogotá, 125 estudiantes de primaria respondieron una encuesta sobre la violencia de su vida diaria y su actitud ante ella. Con intervalos de quince días se les presentó la película 1, violenta, y la película 2, no violenta. Después de cada película, los niños realizaron la prueba del dibujo de familia, escribieron su opinión sobre la película, y respondieron la encuesta. Resultados En la encuesta inicial, 23,6 % de los niños refirió respuestas violentas cuando son agredidos, 39,8 % reportó algún tipo de violencia intrafamiliar y el 19,5 % se identificó con figuras violentas. Los varones fueron más propensos a responder violentamente ante la agresión y a identificarse con figuras violentas (p=0,004). Después de la película violenta, un mayor porcentaje de niños se excluyó a si mismo en el dibujo de familia, comparado con los que lo hicieron después de la película no violenta, Razón de Desventaja (RD) 2,55 (Intervalo de Confianza 95 % (IC) 1,22-5,43, p=0,01). El dibujo de familia de la película violenta presentó mayores frecuencias de signos emocionales que el dibujo 2, RD 3,13 (IC 1,35-7,52, p=0,0053), y más signos de agresividad, RD 2,55 (IC 1,22-5,43, p=0,010). Conclusiones La prueba del dibujo de familia permite evidenciar el impacto inmediato de la televisión. La violencia televisiva afecta negativamente a los niños y debería ser evitada. OBJECTIVE: To evaluate the impact that a violent and a non-violent movie may cause on scholars. METHODS: In Bogotá, 125 public primary school students were surveyed, applying a questionnaire to learn both about their daily life violence and their attitude towards it. Two weeks later, they were shown one violent movie, and two weeks later a non-violent one. Children were asked to draw their families, express their opinions and answer a questionnaire after each movie. RESULTS: The initial survey showed that 23.6% of the children reported violent responses when they were offended, 39.8% reported some kind of familiar violence and 19.5% identified themselves with a violent figure. Boys were more prone to respond violently when offended and to identify themselves with a violent figure than girls (p=0.004). Compared with the non-violent movie, a greater percentage of children excluded themselves from the family drawing after watching the violent movie (Odds Ratio (OR): 2.55; 95% Interval Confidence (95% CI) 1.22-5.43, p=0.01). The family drawing after the violent movie also showed more emotional signs (OR: 3.13; 95% CI: 1.35-7.52; p=0.0053) and more aggressive signs (OR: 2.55; 95% CI: 1.22-5.43; p=0.01) than the family drawing after the non-violent movie. CONCLUSIONS: The family drawing test showed the immediate impact of television. Television violence negatively influences kids and should be avoided.

Objetivos Caracterizar psiquiátrica y socialmente el intento suicida atendido en una clínica infantil de Bogotá, entre 2003 y 2005. Métodos Serie retrospectiva de 96 Casos de 11 a 18 años de edad. Se realizó análisis estadístico univariado y bivariado. Resultados: Las mujeres constituyeron 81,4 %. La edad promedio fue 15,3 años y 70,9 % tenía máximo 16 años. El 63,1 % de familias tenían bajos ingresos. La intoxicación fue el método suicida del 96,9 %. El 38 % tuvo seguimiento ambulatorio máximo por 2 meses. Sólo 13,2 % requirió medicina antidepresiva o moduladora del afecto. El 87,9 % tenía estresantes familiares o escolares. El 83,5 % tenía problemas con los padres, y en 72,3 %, los padres tenían relación conflictiva. Eran primogénitos 46,5 %. Se encontraron 40 situaciones de maltrato. El 27,2 % tuvo intento suicida previo. Los trastornos adaptativos, la disfunción familiar y los trastornos del afecto fueron los principales diagnósticos psiquiátricos. El 37,6 % tenía problemas escolares, pérdida escolar o conflictos con los maestros. El sexo masculino se asoció con agresividad, consumo de sustancias, fracasos escolares o sentimentales y el femenino con ansiedad predominante y maltrato físico. Discusión Se resalta la disminución de la edad, el exceso de representación femenina, la frecuencia alta de conflictos familiares o escolares y la asociación del sexo con perfiles específicos socioculturales, conductuales y emocionales. El conflicto sociofamiliar y escolar es frecuente en el intento suicida juvenil. Es necesario hacer visible la problemática suicida infanto-juvenil para su prevención. OBJECTIVE: Psychiatrically and socially characterising suicide attempts treated at a children's clinic in Bogota, 2003-2005.METHODS: A retrospective series of 96 cases aged 11-18, using univariate and bivariate statistical analysis.RESULTS: 81,4 % of the cases were female. Mean age was 15,3 years and 70,9 % were aged 16 or younger. Low family income was found in 63,1 %. Poisoning was the suicide method in 96,9 % cases. Ambulatory care for two months or less was continued in 38 % cases. Only 13,2 % required anti-depressive or mood-modulator medicine. 87,9 % suffered family or scholastic stress. 83,5 % had a problematic relationship with parents and in 72,3 % of cases the parents had a conflictive relationship. 46,5 % were first-born children. Forty abuse situations were found. 27,2 % had attempted suicide previously. Adjustment disorders, family dysfunction and mood disorders were the main psychiatric diagnostics. 37,6 % had scholastic problems, suffered academic failure or had conflict with their teachers. Males were associated with aggressiveness, substance use, academic failure or romantic loss and females were associated with predominant anxiety and physical abuse.DISCUSSION: Being young, the overrepresentation of females and suffering scholastic and family conflict were noteworthy. Gender association with socio-cultural, behavioural and emotional profile is also worth noting. Socio-family and scholastic conflict is frequent in youth people's suicide attempts. The child-youth suicide problem must be made socially visible to prevent it.