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Introduction: Suicide is a worldwide public health problem, and being the youth are among one of the most affected population groups. In Colombia there is no evidence available about the cost of suicide care or prevention. Or attention to those who make suicide attempts assistance or prevention of suicide. This type of analysis is necessary to guide decisions about resource distribution in mental health and to reduce suicideal rates amongst youths in our country. Thus, the purpose of this study is to estimate and compare the mean cost of in-patient care cost treatment cost of youth suicidal youth suicide attempts, with the mean cost of participation in a school-based suicide preventive prevention program in for adolescents. Materials and methods: Medical charts of adolescents hospitalized for suicideal attempts were reviewed, along with as well as registries from adolescent participants in a suicide preventive program in Bogotá in 2010. Resources used were identified and tariff costs were quantified. Results: The average in-patients cost of a teenage suicideal attempt was {dollar}1 814 000 Colombian pesos (cop) (n = 39) Colombian pesos, and of {dollar}10 307 000 cop (n = 5) Colombian pesos when intensive care was required. The average cost of participation in a prevention ve program was {dollar}113 000 cop (n = 24) Colombian pesos per high-risk teenager and of {dollar}47 000 cop (n = 101) Colombian pesos for teenagers without suicide such risk. Conclusion: With For the average in- patient cost of one suicidal suicide attempt, 16 high-risk teenagers could be enrolled in a suicide preventive prevention program. Introducción: el suicidio es un problema de salud pública mundial, siendo los jóvenes uno de los grupos poblacionales más afectados. En Colombia no hay evidencia disponible sobre el costo de la atención o de la prevención del suicidio. Este tipo de análisis es necesario para guiar las decisiones sobre la distribución de recursos en salud mental y reducir las tasas de suicidio juvenil en el país. Por lo tanto, el objetivo de este estudio es el de estimar y comparar el costo promedio de la atención médica del intento de suicidio de jóvenes, con el costo promedio de un programa escolar de prevención del suicidio, en adolescentes. Materiales y métodos: se revisaron las historias clínicas de los adolescentes atendidos en un hospital por intento suicida, y los registros de los adolescentes participantes en un programa de prevención del suicidio en 2010, en Bogotá. Se identificaron los servicios recibidos, cuanti cándose su valor tarifario. Resultados: el costo promedio de la atención por paciente con intento de suicidio fue de {dollar}1 814 000 (n = 39), y de {dollar}10307000 (n = 5) cuando la atención requirió cuidado especializado. El costo promedio de la participación en el programa de prevención de suicidio fue de {dollar}113 000 (n = 24) por adolescente de alto riesgo y de {dollar} 47000 (n = 101) por adolescente sin riesgo. Conclusión: con el costo promedio de la atención de un intento suicida, se puede realizar un programa de prevención del suicidio con 16 adolescentes de alto riesgo. Introdução: o suicídio é um problema de saúde pública mundial, sendo os jovens um dos grupos populacionais mais afetados. Na Colômbia não há evidência disponível sobre o custo da atenção ou da prevenção do suicídio. Este tipo de análise é necessário para guiar as decisões sobre a distribuição de recursos em saúde mental e reduzir as taxas de suicídios juvenil no país. Portanto, o objetivo deste estudo é estimar e comparar o custo da atenção médica da tentativa de suicídio de jovens, com o custo médio de um programa escolar de prevenção do suicídio em adolescentes. Materiais e métodos: revisaram-se as histórias clínicas dos adolescentes atendidos em um hospital por tentativa de suicídio, e os registros dos adolescentes participantes em um programa de prevenção do suicídio em 2010, em Bogotá. Identi caram- se os serviços recebidos, quanti cando-se o valor tarifário dos mesmos. Resultados: o custo médio da atenção por paciente com tentativa de suicídio foi de $1 814 000 (n = 39), e de $10 307 000 (n = 5) quando a atenção requereu cuidado especializado. O custo médio da participação no programa de prevenção de suicídio foi de $113 000 (n = 24) por adolescente de alto risco e de $47 000 (n = 101) por adolescente sem risco. Conclusão: com o custo médio da atenção de uma tentativa suicida, se pode realizar um programa de prevenção do suicídio com 16 adolescentes de alto risco.

ResumenObjetivoDescribir los efectos de la restricción moderada del sueño en las regiones cerebrales involucradas en los procesos de inhibición cognitiva, función motora y fluidez fonológica, utilizando imágenes por resonancia magnética funcional (RMf).Materiales y métodosSe estableció una condición de sueño habitual y otra de restricción moderada en 12 estudiantes diestros de pre y posgrado de Medicina, de entre 20 y 40 años. En ambos estados se utilizó la prueba psicológica de atención d2 e imágenes de RMf con paradigmas de función motora, fluencia fonológica y atención del tipo inhibición de la función ejecutiva Stroop. La restricción moderada de sueño fue de al menos el 63% con respecto al sueño habitual.ResultadosSe encontraron diferencias significativas en la activación cerebral con RMf para la función motora (p

Introducción. El sueño en adolescentes está influenciado de manera especial por los estados emocionales presentes en las relaciones románticas. Esto puede ser determinante en la percepción de calidad del sueño. Objetivo. Evaluar la asociación entre la percepción de la calidad del sueño y las características de las relaciones románticas en estudiantes universitarios adolescentes y adultos jóvenes. Materiales y métodos. Estudio de corte transversal realizado en 443 sujetos. La percepción de calidad del sueño, los estilos de apego, estar en una relación romántica y sus características se determinaron utilizando medidas validadas. Resultados. La percepción de calidad del sueño se determinó utilizando cinco modelos multivariados que incluyeron características estadísticamente significativas de las relaciones románticas. El nivel de satisfacción del individuo con su relación de pareja y la atracción hacia esta se asoció con su nivel de percepción de calidad del sueño (p=0.035). La prevalencia de las relaciones románticas fue del 64% (IC95%: 59.4-68.9). Los que no estaban en una relación experimentaron latencia del sueño significativamente más prolongada (p

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

Introduction: The 5-HTT short allele has been controversially associated with an increased risk of major depressive disorder. Objective: To determine the association of 5-HTT short allele with major depression in Bogotá, Colombia. Materials and methods: We carried out a study of cases (n=68) matched 1:1 with controls by gender and age (±5 years). Major depression was diagnosed using the Mini-International Neuropsychiatric Interview, and 5-HTT polymorphism using PCR. Results: Females were predominant (82.4%). The S (short) allele predominated in cases compared with controls (S: 72.1% vs. 63.2; L (long): 27.9% vs. 36.8%), and the SL genotype was more frequent in cases (SL: 45.6% vs. 36.8%; LL: 27.9% vs. 36.8%; SS: 26.5% vs. 26.5%), although not significantly. There were significant differences in those under age 37, with a predominance of the S allele in cases (p=0.038; OR=2.75; 95% CI: 0.88-8.64). Multivariate analysis, adjusted for comorbid anxiety disorders, showed a significant association of major depression with the SL genotype (p=0.049; OR=3.20; 95% CI: 1.00-10.23); the S allele was close to statistical significance (p=0.063; OR=2.94; 95% CI: 0.94-9.13), and it was statistically significant in cases under 37 years of age (p=0.026; OR=10.79; 95% CI: 1.32-80.36). Conclusions: The SL genotype was associated with major depressive disorder in patients of all ages. The S allele was significantly associated with major depressive disorder in patients under age 37, adjusted for comorbid anxiety disorders. 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; IC 95% : 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; IC 95% 1,003-10,233); el alelo S estuvo cerca de la significación estadística (p=0,063; OR=2,94; IC 95% 0,94-9,13), y fue estadísticamente significativo en los casos de menores de 37 años (p=0,026; OR=10,79; IC 95% 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.

Introdução: O abandonoe atrasonos cursosde educação superior naColômbia e no mundoconstituem um problema de grande magnitude que afeta cerca do 50 % de estudantes e leva um alto impacto pessoal, social e económico. Materiais e métodos: Descrever as características da deserção estudantil no curso de medicina da Universidad del Rosario e as variáveis associadas ao mesmo. Se realizou um estudo descritivo retrospectivo das coortes que ingressaram nos dois períodos acadêmicos do 2003 e da informação acadêmica das coortes de estudantes registrados no curso entre os anos 2003 e 2008. Os dados se analisaram desde as perspectivas longitudinal e transversal. Resultados: A desvinculação definitiva total nas coortes que ingressaram nos dois períodos acadêmicos de 2003 foi de 47 % e 36 %, a desvinculação temporal foi de 29 % e 36 %, e obtiveram o grau no tempo previsto o 22 % e 19 % dos estudantes respetivamente. A desvinculação média em cada período acadêmico entre 2003 e 2008 foi 7,1 %. A principal explicação para a deserção foi de índole acadêmica. Discussão: as percentagens de deserção e o atraso acadêmico no currículo tradicional de medicina entre 2003 e 2008 foram altos, similares aos da educação superior na Colômbia. Entre a complexidade que caracteriza este fenômeno, as estratégias pedagógicas e os aspetos acadêmicos ecurriculares parecem desempenhar um papel preponderante. Esta coorte histórica e seus indicadores de deserção servirão de base de comparação para o novo currículo do programa de Medicina recentemente instaurado.

Resumen Objetivos Determinar la probabilidad de riesgo suicida y/o enfermedad mental y factores asociados en estudiantes de secundaria de tres colegios bogotanos. Metodos Estudio de corte transversal con 309 adolescentes. Resultados El promedio de edad fue de 13,83 ± 0,9 anos, predomino el genero femenino (58,6%) y el estrato socioeconomico 3 (68,3%). La probabilidad de riesgo para comportamiento suicida y/o sintomas mentales fue de 47,6%; 26,5% tuvo alguna manifestacion suicida; 14,23% tuvo ideacion suicida en los ultimos tres meses; 3,55% tuvo intentos suicidas alguna vez en la vida, y 8,73% tuvo ideacion suicida e intentos suicidas en los ultimos tres meses. El riesgo de comportamiento suicida y/o enfermedad mental fue explicado conjuntamente por la depresion (OR = 27,9, IC95% = 3,5-223,1), la baja autoestima (OR = 11,8, IC95% = 2,5-56,5), la disfuncion familiar severa (OR = 3,4, IC95% = 1,2-9,7), el sexo femenino (OR = 2,1, IC95% = 1,2-3,8) y la edad mayor o igual a 15 anos (OR = 1,9, IC95% = 0,9-3,9). El maltrato psicologico seguido del abuso fisico se asociaron con manifestacion suicida y/o enfermedad mental, y la buena relacion familiar, con menor probabilidad. Conclusion La depresion, la baja autoestima, la disfuncionalidad familiar, el genero femenino, la edad ≥ 15 y la violencia intrafamiliar son factores asociados al riesgo suicida y/o enfermedad mental en adolescentes, y las buenas relaciones familiares se asocian con menor riesgo.

Introducción: Tener un padre con enfermedad mental es considerado una adversidad crónica y un factor de riesgo para múltiples desenlaces. Las investigaciones sobre las experiencias de vivir el día a día con un padre o madre con enfermedad mental son extremadamente escasas. Objetivo: Explorar cómo entienden los niños la enfermedad mental de sus madres y qué aspectos se relacionan con su comprensión. Método: Se utilizó un modelo cualitativo interpretativo (la teoría fundamentada) aplicado a 13 entrevistas semiestructuradas realizadas en niños con edades entre 8 y 16 años que viven con la madre que tiene esquizofrenia, depresión mayor o trastorno afectivo bipolar. Resultados: Se elaboró un modelo teórico acerca de los factores relacionados con las experiencias y la comprensión de tener y vivir con una madre que tiene enfermedad mental. Está compuesto por cuatro conceptos: (1) características de la enfermedad, (2) información sobre la enfermedad mental, (3) explicaciones sobre la enfermedad mental y (4) consecuencias Conclusiones: Este estudio mostró los factores primordiales que le ayudan al niño a realizar una explicación de la enfermedad mental. También muestra cómo la familia no está preparada ni abierta para hablar con el niño de la enfermedad mental y cómo los niños sienten que la red de salud mental no es una fuente de apoyo o de información Introduction: To have a parent with a mental illness is considered a chronic adversity and a risk factor with diverse outcomes. Research on the experiences of living day to day with a parent with mental illness is extremely rare. Objective: To explore how children understand the mental illness of their mothers and aspects that are related with their comprehension. Method: An interpretative qualitative model was used (Grounded Theory) to analyze data from 13 semi-structured interviews conducted among children between the ages of 8 and 16 years living with their mothers who have diagnoses of schizophrenia, major depression or bipolar disorder. Results: We developed a theoretical model regarding the factors that are related to the experiences and understanding of having and living with a mentally-ill mother. The model is composed of four concepts: (1) Characteristics of the disease, (2) information about mental illness, (3) explanations of mental illness, and (4) consequences. Conclusions: This study showed the main factors that help the child explain the mental illness. It also indicated that the family is not ready or open to talk with the child about the mental illness, and how the child feels that the mental health network is not a source of information or support

Objective 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. Methods 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. Results 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. Conclusion 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. Language: es

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.

Introduction: Comprehensive undergraduateeducation in clinical sciences is groundedon activities developed during clerkships. Toimplement the credits system we must knowhow these experiences take place.Objectives: to describe how students spendtime in clerkships, how they assess the educativevalue of activities and the enjoyment it provides.Method: We distributed a form to a randomclustered sample of a 100 students coursing clinicalsciences, designed to record the time spent,and to assess the educative value and the gradeof enjoyment of the activities in clerkship duringa week. Data were registered and analyzed onExcel® 98 and SPSS.Results: mean time spent by students inclerkship activities on a day were 10.8 hours. Ofthose, 7.3 hours (69%) were spent in formaleducation activities. Patient care activities withteachers occupied the major proportion of time(15.4%). Of the teaching and learning activitiesin a week, 28 hours (56%) were spent in patientcare activities and 22.4 hours (44.5%) were usedin independent academic work. The time spentin teaching and learning activities correspondto 19 credits of a semester of 18 weeks. Theactivities assessed as having the major educationalvalue were homework activities (4.6) andformal education activities (4.5). The graded asmost enjoyable were extracurricular activities,formal educational activities and independentacademic work.Conclusion: our students spend more time inactivities with patients than the reported in literature.The attending workload of our students isgreater than the one reported in similar studies.

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.

To establish the probability for suicide risk and/or mental disorders, together with related factors among high school students in 3 schools in Bogota.Cross sectional study of 309 adolescents.The average age was 13.83 ± 0.9, female dominance (58.6%) and a 3(rd) socioeconomic stratum (68.3%). The suicidal risk behavioral probability and/or mental symptoms was 47.6%, 26.5% exhibited some suicide manifestations, 14.23% had experienced suicidal ideas in the last 3 months, 3.55% had had suicide attempts at least once in life, and 8.73% had suicidal ideas in the last 3 months with suicide attempts. The risk of suicidal behavior and/or mental disorders was explained jointly by depression (OR=27.9, 95% CI: 3.5-223. 1), low self-esteem (OR=11.8, 95% CI: 2.5-56.5), severe family dysfunction (OR=3.4, 95%CI 1.2-9.7), being female (OR=2.1, 95% CI: 1.2-3.8) and being 15 or older (OR=1.9, 95% CI: 0.967-3.9). Psychological abuse followed by physical mistreatment was associated with suicidal behavior and /or mental illness while good family relationships were associated to lower probability.Depression, low self-esteem, severe family dysfunction, female gender, older age (≥15) and domestic violence are risk factors associated with suicide and/or mental disorders in adolescents; good family relationships are associated with lower risk.

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.

Introducción: La formación en ciencias clínicas del pregrado de medicina se fundamenta en rotaciones clínicas. Para implementar el sistema de créditos es necesario conocer cómo se llevan a cabo estas experiencias. Objetivo: Describir cómo los estudiantes utilizan el tiempo durante las rotaciones clínicas, el valor académico y el grado de disfrute que le asignan a las actividades. Metodología: Estudio descriptivo con una muestra aleatoria estratificada de cien estudiantes de los semestres clínicos. Se recolectó información sobre el tiempo empleado durante una semana, el valor educativo y el grado de disfrute de las actividades de las rotaciones clínicas. Los datos fueron analizados en Excel® 98 y SPSS. Resultados: Las actividades de un día ocuparon en promedio 10.8 h, con 7.3 h (69%) dedicadas a actividades académicas. La actividad asistencial con docente representó el mayor porcentaje de utilización del tiempo (15.4%). Durante una semana, el 56% (28 h) del tiempo efectivo estuvo dedicado al trabajo asistencial y 22.4 h (44.5%) al trabajo independiente en el sitio de práctica. El tiempo dedicado al aprendizaje en la rotación clínica corresponde a 19 créditos para un semestre de 18 semanas. Las actividades calificadas con mayor valor educativo fueron el estudio independiente por fuera de la institución (4.6) y las actividades académicas con el docente (4.5). Las calificadas como de mayor disfrute fueron las extracurriculares y la docencia formal. Conclusiones: Los estudiantes tienen mayor tiempo de contacto con los pacientes que el reportado en la literatura. El trabajo presencial de nuestros estudiantes es mayor al reportado en estudios similares. Introduction: Comprehensive undergraduate education in clinical sciences is grounded on activities developed during clerkships. To implement the credits system we must know how these experiences take place. Objectives: to describe how students spend time in clerkships, how they assess the educative value of activities and the enjoyment it provides. Method: We distributed a form to a random clustered sample of a 100 students coursing clinical sciences, designed to record the time spent, and to assess the educative value and the grade of enjoyment of the activities in clerkship during a week. Data were registered and analyzed on Excel® 98 and SPSS. Results: mean time spent by students in clerkship activities on a day were 10.8 hours. Of those, 7.3 hours (69%) were spent in formal education activities. Patient care activities with teachers occupied the major proportion of time (15.4%). Of the teaching and learning activities in a week, 28 hours (56%) were spent in patient care activities and 22.4 hours (44.5%) were used in independent academic work. The time spent in teaching and learning activities correspond to 19 credits of a semester of 18 weeks. The activities assessed as having the major educational value were homework activities (4.6) and formal education activities (4.5). The graded as most enjoyable were extracurricular activities, formal educational activities and independent academic work. Conclusion: our students spend more time in activities with patients than the reported in literature. The attending workload of our students is greater than the one reported in similar studies.

Introducción: el abandono y rezago en los programas de educación superior en Colombia y el mundo constituyen un problema de gran magnitud que afecta alrededor del 50 % de estudiantes y conlleva un alto impacto personal, social y económico. Materiales y métodos: describir las características de la deserción estudiantil en el programa de medicina de la Universidad del Rosario y las variables asociadas. Se realizó un estudio descriptivo retrospectivo de las cohortes que ingresaron en los dos periodos académicos de 2003 y de la información académica de las cohortes de estudiantes registrados en el programa entre los años 2003 y 2008. Los datos se analizaron desde las perspectivas longitudinal y transversal. Resultados: la desvinculación definitiva total en las cohortes que ingresaron en los dos periodos académicos de 2003 fue de 47 % y 36 %, la desvinculación temporal fue de 29 % y 36 %, y obtuvieron el grado en el tiempo previsto el 22 % y 19 % de los estudiantes, respectivamente. La desvinculación promedio en cada periodo académico entre 2003 y 2008 fue 7,1 %. La principal explicación para la deserción fue de índole académica. Discusión: los porcentajes de deserción y el rezago académico en el currículo tradicional de medicina entre 2003 y 2008 fueron altos, similares a los de la educación superior en Colombia. Entre la complejidad que caracteriza este fenómeno, las estrategias pedagógicas y los aspectos académicos y curriculares parecen desempeñar un papel preponderante. Esta cohorte histórica y sus indicadores de deserción servirán de base de comparación para el nuevo currículo del programa de Medicina recientemente instaurado. Introduction: Dropout and graduation delay in higher education programs are a major problemworldwide, therefore also in Colombia, where it affects about 50 % of the students, a fact thatproduces a high personal, social and economic impact. Objective: To describe the characteristics of the dropout and graduation delay of Medical School students at the El Rosario University, and its associated variables. Materials and methods: A retrospective, descriptive study of the two cohorts admitted in 2003 and of the academic information of students enrolled during the years 2003 through 2008 was performed. Data were analyzed from longitudinal and transversal perspectives. Results: Longitudinal analysis showed that both cohorts admitted in 2003 had a dropout rate of 47 % and 36 %, graduation delay of 29 % and 36 %;and 22 % and 19 % of the students, respectively, obtained their degree in the expected time. The mean dropout per academic period between 2003 and 2008 was 7.1 %. The main reason for dropout was academic failure. Discussion: The dropout and graduation delay rates in the traditional curriculum of the Medical School between 2003 and 2008 were high, similar to those found in higher education in Colombia. Among the complexity that characterizes this phenomenon, teaching strategies and academic and curricular aspects seem to play a major role. This historical cohort and the associated dropout indicators will serve as a basis for comparison for the new curriculum of the Medical School program recently established. Introdução: O abandonoe atrasonos cursosde educação superior naColômbia e no mundoconstituem um problema de grande magnitude que afeta cerca do 50 % de estudantes e leva um alto impacto pessoal, social e económico. Materiais e métodos: Descrever as características da deserção estudantil no curso de medicina da Universidad del Rosario e as variáveis associadas ao mesmo. Se realizou um estudo descritivo retrospectivo das coortes que ingressaram nos dois períodos acadêmicos do 2003 e da informação acadêmica das coortes de estudantes registrados no curso entre os anos 2003 e 2008. Os dados se analisaram desde as perspectivas longitudinal e transversal. Resultados: A desvinculação definitiva total nas coortes que ingressaram nos dois períodos acadêmicos de 2003 foi de 47 % e 36 %, a desvinculação temporal foi de 29 % e 36 %, e obtiveram o grau no tempo previsto o 22 % e 19 % dos estudantes respetivamente. A desvinculação média em cada período acadêmico entre 2003 e 2008 foi 7,1 %. A principal explicação para a deserção foi de índole acadêmica. Discussão: as percentagens de deserção e o atraso acadêmico no currículo tradicional de medicina entre 2003 e 2008 foram altos, similares aos da educação superior na Colômbia. Entre a complexidade que caracteriza este fenômeno, as estratégias pedagógicas e os aspetos acadêmicos ecurriculares parecem desempenhar um papel preponderante. Esta coorte histórica e seus indicadores de deserção servirão de base de comparação para o novo currículo do programa de Medicina recentemente instaurado.